@Kit_Cat I’ve attached your axial slice at the level of C1 with annotations. Couple of standouts with your imaging. Your left ijv does in fact look thrombosed - evidenced by the lack of contrast in it. Based on my research, it appears this can happen in people with ES, as the styloid and C1 causes compression and clotting in the area.
I don’t think this necessarily means that the vein is chronically thrombosed. It’s possible that it lets loose every now and again, but this type of medical stuff is out of my wheelhouse. Regardless of acute or chronic thrombosis, it’s clear that your left IJV could be causing some of your symptoms. It’s hard to tell if your left styloid is part of the equation here though because I can’t tell if it’s in contact with the vein. It’s possible that C1 is solely causing the IJV compression. Hard to tell without the contrast in the vein.
Your right IJV appears to be pancaked against C1. The styloid seems to be distant from the vein, at least in this view. Now that you know what is what in this axial view, you can follow your right IJV all the way up to the skull base and down to the heart to see where the compression worsens. Can’t do that with the left ijv though since it lacks contrast.
Hope this helps!
