Thank you! I’ll play around with it tomorrow. I’m not very tech savvy. It’s on my OneDrive at the moment.
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Onedrive will work I think!
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@Michelled see attached annotated images.
Both of your styloids are compressing/displacing your IJVs at the upper layer of C1. A bit further down, your left IJV is compressed against the left wing of your C1 transverse process.
A bit further down, your ICAs and IJVs pass each other and swap positions. I have only ever seen this a couple times. Usually the ICA remains anterior of the IJV (i.e., remains in front of the IJV down the full length of the neck). When they pass each other, they are being compressed against each other, particularly on your right side. Not sure if this is causing any symptoms or has the potential to, but definitely something to consider. When you see the ICAs move like that it’s typically referred to as “tortuous” ICA. Usually it’s side to side, but yours is forwards and back.
Even further down, the tip of your left styloid is pressing against your left ECA. Head movements could be causing the tip to cause mechanical irritation to the ECA.
Your left styloid is over 3cm while your right styloid is average length. However, they are both causing problems so I think it’s justifiable to get them both out (but cut above C1 so that IJV decompression actually occurs). A left C1 shave may also provide some relief but I’m not sure.
Hope this help! (reminder that I am not a doctor nor radiologist!)
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Thank you so much!!
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Do you happen to know which doctors deal with all of this that I can check into? Dr. Hackman that I was wanting to see if I’m remembering right doesn’t deal with vascular eagles
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@Isaiah_40_31 and @Jules will be best to help give you an idea of which doctors you should touch base with. Many can do virtual consults which is good, but some have long wait times.
All ES surgeons who cut styloids above C1 can help vascular-wise. I think Dr. Hackman does if I remember correctly. If you need a C1 shave to further open up the IJVs than that is what changes things - you’d need to find a surgeon who does C1 shaves
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Now you have the insight from @TML , it might be an idea to have a consultation with one of the VES doctors if you can- Dr Costantino in NY, Dr Hepworth in CO or Dr Nakaji in AZ are the best doctors. There’s also Dr Fargen in NC, he’s knowledgeable about vascular ES, but hasn’t actually done many styloidectomies, I’ve mentioned him as he’s nearer & it’s helpful to get some opinions…here’s a link to the list:
Doctor Lists – no discussion - Symptoms and Treatments / Doctor Information - Living with Eagle
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