Seems like I have some pressure drop in my dominant tranvese Sinus from my arachnoid granulation but biggest finding was huge pressure gradient when I turn my head left on the left side that indicated IJV stenosis and I have a ton of big collateral veins
I will post pictures of my left side scan from months ago .. my jugular in neutral is fine but only compresses when turning head left
The issue is my symptoms are constant and actually won’t get any worse with head turning so it’s hard to tell if it’s the TS or positional IJV that’s bothering me
Have follow up with neurosurgeon in two weeks and will consult soon with Dr costantino
Just not sure what to do
And of course my symptoms are very flared up from the cerebral angiogram right now
It appears your left IJV is your dominant one, & your right side is fairly diminutive. It also looks to me like your IJVs are mostly being compressed from behind by the transverse processes of your C1 vertebra, as I don’t see your styloids, only bits of calcified stylohyoid ligaments. Your ligament calcifications appear to be sitting on your external carotid arteries on both the left and right though it’s hard to tell for sure if the calcifications are making contact with the ECAs or are just suspended above them because of the angle of the image.
In the image below, I labeled what could be your right styloid, but it looks detached from your skull base so might be calcified stylohyoid ligament instead. I also noted that both IJVs look like they may be compressed lower down. The right one in particular looks like it could have some pressure from your right ICA on it & the left one, too, but less so. When compression appears lower in the neck like that it can be coming from the SCM or other sources.
In the image below you can see the transverse processes of C1 pressing into the back sides of your IJVs & can more clearly see the ICAs putting pressure on your IJVs.
I wouldn’t like to say, I don’t know enough about the pressure gradients etc, I think you’ll have to be guided by your doctors on this one… I’m sorry, I can’t remember, were you going to try & see Dr Nakaji as well?
@Deanm can you go to the axial view of your CT imaging and go to C1? I’ve attached my own to help you know what to look for. Look for the top vertebrae with a white circle in the top middle. It’ll help us see if your IJVs are pancaked against C1 and whether the calcifications are in contact or not
