Can anyone help me understand this part of my Venogram? Brain fog is thick. My follow up is a month away and would like to start preparing questions.

“We pulled the catheter back into the subclavian vein and redirected into the left internal jugular venous system. We found a large medial branch which went up into collaterals and with a large amount of vertebral small vessels feeding into this vein. We identified a more lateral jugular vein and the catheter was able to pass to the skull base. There we found a much smaller vein with very few collaterals extracranially and then at about C2 went into 2 smaller branches. We chose the larger of the 2 branches, went to the skull base and replaced the wire.”

The best I can tell you is that collaterals are mentioned a couple of times. As far as I understand it, collateral veins form when blood flow through the main vessels is inadequate. The collaterals are your body’s way of working around the “kink in the hose” to increase blood flow efficiency where it’s lacking.

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I would add that the language may suggest a unusual venous structure has developed, likely as result of compression of JV. I had a collateral vein on imaging & one JV was split in 3 near top, but the language suggests maybe a more complex venous deviation has developed here. Did they report the venous sinus pressures to you? Worth reviewing them in detail if so to see where higher pressures are and if there is any gradient difference reported between one side of brain to the other. Take care. D


Thank you so much @Isaiah_40_31 and @PatientD for sharing your thoughts with me.

@PatientD This venogram/IVUS was done during my very recent styloidectomy and jugular decompression on my right side. After making sure the right side was open after decompression (right collaterals disappeared) they checked the left side which showed that. I have not had my venous sinus pressures taken yet but it has been suggested by my surgeon as CT shows the left transverse sinus being teeny tiny. That’s so interesting about your jugular vein split 3 ways near the top. Amazing what our bodies can do.


Yes our bodies are determined to survive & can do some strange things to adapt. My JV split was caused by bad childhood fall I believe, jaw was deranged on that side too. Think collateral vein was grown to try& help blood drainage on that damaged side. Hope your surgery has helped & that you get any more help needed soon. D


That all makes sense. I also had a bad fall on my left side in my teenage yrs. Thank you so much. I hope you continue to see some improvements and experience less and less symptoms.