Dr Hepworths pa did have a ctv done it only showed .mild jug I have to find it and post is there another test for this?
FINDINGS:
Noncontrast head CT:
Brain volume and ventricular size are normal. No focal parenchymal abnormalities. No evidence for hemorrhage or infarction. No subdural or epidural collection. No midline shift or mass effect. The skull is intact. The paranasal sinuses and mastoid air cells are clear.
CT venogram:
There is no abnormal enhancement within the brain. The dural venous sinuses, straight sinus and deep cerebral veins are normally enhancing. Superficial cortical veins show normal enhancement.
The arteries of the neck are unremarkable. The jugular veins are normal and symmetric in appearance. They are normally enhancing.
As described on the prior study, prominence of the styloid process and/or calcification of the stylohyoid ligament noted. On the coronal images, the left side shows an overall superior to inferior length of 2.7 cm, and the right side shows length of 3 cm. Average length is approximately 2.5 cm and over 3 cm is considered elongated. On the axial images, there is subtle effect upon the anterior aspect of the proximal left jugular vein, without significant compression. This does not affect the adjacent internal carotid artery.
On the right side, there is subtle flattening of the anterior aspect proximal jugular vein, without severe compression. It does not affect the right internal carotid artery.
Soft tissues of the neck are unremarkable. There is no mass or significant adenopathy. Straightening of the cervical spine noted, with moderate to severe degenerative change from C3 through C7. No severe bony canal stenosis.
IMPRESSION:
As noted on the prior study, there is slight prominence of the styloid process, but not measuring over 3 cm in length. There is subtle effect upon the anterior aspect of the proximal jugular vein bilaterally, but no severe compressive effect. There is no effect upon the internal carotid arteries.
The remainder of the brain and neck are unremarkable.
Thank you for this referral. This examination was interpreted by a Colorado Imaging Associates radiologist. Providers with questions may reach a radiologist directly at 303-223-4448.
Final Electronic Signature: This report was electronically signed by David Goodbee, MD on 8/11/2021 8:58 AM.
dgoodbee /
NJ
I am assuming your head was in a neutral position when this test was done. The mere fact that slight compression of your IJVs bilaterally was noted could mean that with your head in any other position, the compression on one side or the other (depending on head position) could become significantly worse. This is something that I don’t think doctors think about, or they would order the scans to be done w/ the patient’s head in the position that “provokes” symptoms i.e. makes them worse, yet they consistently order these scans w/ the head in a neutral position which is asymptomatic for most people.
Another test that is done to check for blood flow through the veins is a venogram. Ultrasound is used to watch the blood flow. If you are to get a venogram, you should insist that the referring doctor, &/or doctor who does the scan, allow you to have it done w/ your head in the position(s) that make you feel the worst. That will be much more telling regarding how compressed your IJVs actually become w/ head movement.
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Correct it was in a stationary position, you think Dr Hepworth pa would know this but maybe because of those results he will order additional testing hope so anyway…thank you for your help I seem to have more symptoms when I bend my neck forward or in fetal position
That “Straightening of the cervical spine noted” sounds like the “military neck”, and somehow I can’t avoid noticing that longer styloids and the “military neck” often occur together, from my observations here, on the forum. maybe that is one of the factors why some people have no symptoms from elongated styloids while others do have…
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One thing I noticed in this report is the radiologist said “over 3.0 cm is considered elongated.” Much of the expert data on ES indicates anything over 2.5cm and with symptoms falls into Eagles realm. Many radiologists are not fully educated on Eagles and why it is best to have an ES surgeon who reads the scans personally and not rely on a radiologist report. I’m assuming Dr. Hepworth might do this? I would ask about this. Maybe even make an appt for a consult to review scan with him directly? I assume radiologist sent scan on disk to Dr. Hepworth? You may have to sign a release to have that done. I also sign a release to get a copy of all my scans for my own records and to have on hand when I go to appt in the event doc doesnt have it.
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Thank you Dr Hepworths pa actually ordered the scan and I see him Oct 15 so surely he will go over with me I also think I need the ultrasound so I will ask him about that too
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