Good morning to all 
I met with the interventional neuroradiologist (IN) virtually to discuss my dynamic Angiogram before the planned surgery. The IN explained that my IJV cannot drain properly, on top of of my IJV being squeezed between Styloïd bone and C1.
My question is: is the draining issue part of VES?
I googled my question but not sure I understand well.
Thanks 
Audrey
@Hamela Yes. Our circulatory system is a closed system meaning if blood doesn’t flow out as it should (veins), blood can’t flow in as it should (arteries). The build up of pressure that is created and the poor exchange of oxygen and nutrients to the brain are at the root of many VES symptoms. Additionally, CSF pressures need to be higher (about 5-10 mmHg) than venous pressures to allow CSF to drain into the venous system. So depending on how elevated venous pressure is (due to stenosis between styloid and C1) CSF pressure can elevate enough to also create symptoms. Hope that helps.
Hi @Chrickychricky ,
It helps very much to understand. Now I understand more about the blood flow, and it makes sense the dynamic Angiogram is required before the surgery.
Many thanks for your response
Best!
Audrey
Generally it’s a venogram to look at venous pressures because it’s a venous stenosis. You might want to ask about why an angiogram and not a venogram.
Hi,
Yes, it’s a very good question. I had a CT Scan with contrast (CTV) already last October, this is where my styloid bone is shown compressing my C1, along with calcified ligaments.
I also have enlarged jugular bulb, and enlarged emissary veins…the full package 
Please let me know your opinion, you know way more than me.
Thanks!!
Audrey
Thanks @Chrickychricky for that info & explaining it so well…would be a good question to ask about the angiogram rather than a venogram as she suggests @Hamela , unless they want to see if there’s any arterial compression as well?
Hi @Jules
Yes, it’s a possibility, maybe I have artery compression. I have large soft lump above the collar bone, it could be a sign.
Thanks
Audrey
I noticed codes on the form from my American specialist who will perform the dynamic Angiogram.
Every specific procedure is assigned a code for the dynamic Angiogram (invoices). For instance, I can see codes 36224 to 36227, one of those codes is related to the assessment of the vertebral artery. It can explain some things.
Thanks for your support 
Audrey
If the issue is venous stenosis, they usual test is a venogram where they insert a catheter in the femoral vein and work their way up. During this procedure they do manometry testing to look for pressure gradients across the Styloid/C1 stenosis. My own experience was that I had both a venogram and an angiogram. The angiogram was mainly looking for dangerous causes of the pulsatile tinnitus.
Bilateral VES. Stenosis between C1 and elongated styloids
@Hamela, @Chrickychricky, @Jules - The term angiogram is often used in a general way for both angio & venograms. Hamela is possibly getting both but just under the name angiogram.
@Isaiah_40_31 good knowledge!
Is your stenosis the same as compression? I checked on Dr. Google and they seemed different depending on the source.
Thanks
Audrey
Compression between elongated styloid and C1 causes stenosis of the IJV where is runs between those structures
I see!
Thanks
Audrey