Hey everyone, I’ve been dealing with vitreous floaters since I was 17, and over time (I’m 24 now) they’ve gotten worse. In the past two years, things have become especially bad, with a significant increase in the Bluefield entoptic phenomenon and visual snow.
More recently, I’ve also started seeing slight double vision and developed tinnitus in one ear.
When I turn my head to the right, I can slightly hear my pulse. I believe I have a jugular vein stenosis, and after many exhausting doctor visit: ophthalmologist, neurologist, etc.
I was finally sent for an MRI, which came back without any findings. However, I took another close look myself and think that my atlas vertebra is compressing my left jugular vein.
What do you think about the image? Do you think this could be the case? I’ve also included the right side for comparison and am curious about your opinion.
I also saw a new doctor who has now prescribed a CT scan with contrast. The referral states: ‘Cervical spine CT scan with contrast.’ Is that enough to detect such a stenosis, or does something more specific need to be mentioned?
In the worst case, I could do the 3-D graphics at home Right?
Shortly before all these issues started (about six months earlier before the first floaters) something cracked slightly in my neck while I was running. After that, I couldnt see anything at all for about five minutes and wasnt really able to move for the next half hour. However, I never went to a doctor because everything was back to normal the next day. I suspect that my atlas vertebra may have shifted at that moment.
Yes, it does look like it could be compressing the IJV against the styloid process, the right side looks like it could be a bit compressed too, but not as much. It’s unusual for the styloids to be shown so much, they look from your images to be longer than average & possibly a bit thicker too. Sometimes removing the styloids is enough to make space for the IJVs, sometimes a C1 shave is needed…
There are a few doctors in Germany who do styloidectomies, Dr Heim who was fairly experienced has gone into private practice though. Here’s a link to the Doctors List, although I’m sure @Isaiah_40_31 probably already gave you that: Doctor Lists – no discussion - Symptoms and Treatments / Doctor Information - Living with Eagle
There’s info at the end of this discussion with an update about Dr Heim: Updates on Dr. Heim? - General - Living with Eagle
It doesn’t sound like anyone in Germany is doing C1 shaves though, that we know of anyway, so see what the CT shows…
A CT of the cervical spine with contrast should be enough; you could just double check it’ll cover from the skull base down to the hyoid bone, that is all in the same length of the cervical vertebrae, so should be fine.
@dark27, I agree w/ @Jules about the bilateral compression & styloid/C1 involvement especially on the left side. If you do get a definitive diagnosis of IJV compression & ES, you’ll likely have to travel outside of your country to see a surgeon experienced w/ ES & IJV decompression surgeries. There are other members on our forum from Germany who’ve needed to do that as well.
