My scan Images

https://www.dropbox.com/sh/1epbpz3vaev80av/AAB-Df_lFBuDy9ZuHoq_WrDIa?dl=0

Above is a link to view a few of my scan images that I can see an abnormality on the vertebral around V3 level at the atlas loop.  Two Interventional Radiologists from New York and India have reported on my scans.  Another doctor from Florida suggested a healed vertebral artery dissection where a haematoma has penetrated the three layers of the artery and created a double lumen of the artery which basically means the artery has two channels at a small part of the artery at the back of the atlas loop where blood flow is being pushed through both channels.  I now understand why I am hearing the turbulent rhythmic sound in my head, its due to the blood flow,  I can imagine if a hose had water pumping through it and the hose split into two channels and then met up again then the sound would be turbulent.

I believe my symptoms are real and of someone who has experienced a VAD. I can see the images are showing evidence of a VAD.  The NHS (National Health Service) do not agree and state my MRA scan is normal.  My Neurologist Dr Tyagi stated to me and Mr Wanderer that the scan has picked up something that is not there and that the scan is normal.  I have unfortunately lost trust in all of these doctor's who have constantly closed doors and not allowed proper investigations to take place when I first presented.  My MRA was arranged by myself two years after my symptoms started as my GP would not refer me to Neurology.

While I have researched constantly on my symptoms I won't stop until I have definite answers.  I speak with so many sufferers who are experiencing pulsatile tinnitus and many do indeed receive a diagnosis.  It takes an astute doctor to question what their patient is presenting with, unfortunately for the rest of us our doctor's put us into the tinnitus bracket even though we explain a baby ultrasound rhythmic sound in time with the pulse.  There are many doctors who will also agree that their patient is suffering from pulsatile tinnitus and believe it needs no medical work up as they assume it is normal tinnitus which simply pulses.  This is a myth and after searching through hundreds of medical reports of which I would say 80% were all blood flow restrictions within the head and the other 20% were tumors.  I came across an extensive list of possible causes of pulsatile tinnitus.  A few of which were Carotid Dissection, Vertebral Dissection, Aneurysm in the arteries and veins, Dural Arteriovenous Fistula, Stenosis of the sigmoid and transverse sinuses (veins leading to the jugular) Ateriovenous Malformation, Temporal bone defects, Superior Canal Dehiscence & High riding jugular bulb.  The most important thing to remember is most of these causes can be diagnosed and can be treated.  Doctor's need to realise that any small stenosis either in the veins or arteries carries a risk of stroke.  I would immediately think that doctor's would want to investigate pulsatile tinnitus symptoms when any of their patients present with it.

It leads me to question how much training are GP's in the UK given on tinnitus and pulsatile tinnitus?  Surely with advancing medicine refresher courses and on going training would cover pulsatile tinnitus.  And finally PULSATILE TINNITUS IS NOT TINNITUS  My acronym suits this condition perfectly which is RATS.  Rhythmic Arteriovenous Tinnitus Sounds!  When a patient presents with RATS a GP should ask the patient to take their pulse with three fingers on their wrist and see if the sound in their head matches what they feel on their wrist, another option is to ask the patient to tap out the rhythm with a finger on the desk.

All for now Whirring Wanderer

May 2015 Update

Wednesday 6th May  I called my GP surgery to see if they had heard from my Neurologist as I had yet to receive a letter about my results of the CT Angiogram that I was promised.  The receptionist confirmed that they had indeed received a report from Dr Tyagi on the 16th April and that it was noted I had been sent a copy of the report.  I explained that I had received nothing.  The receptionist suggested that I call the hospital.  I decided to email Dr T again to remind him I had still not received the promised report/letter or a hard copy of the CTA that had been promised nor a follow up appointment. I explained how I was still suffering and no one was helping me and I reminded him that I'd been doing all the chasing and investigating my symptoms from January to May. He responded by asking that I go to the hospital the next day on the 7th May.  I called my husband Mr Wanderer but he was unable to get time off work at such short notice.  Dr T responded and asked that I visit the hospital on the 20th May at 1.30pm and copied his secretary into the email.  I spoke to Mr Wanderer again and he said he could take a holiday from work that day. 


On the day I felt a bit apprehensive, I had this strange feeling that something wasn't right and wouldn't go to plan but I kept telling myself I was being silly. 


We arrived five minutes early to find the reception, when I spoke to check in the reception chap said I was already checked in. The receptionist was slightly puzzled and repeated my name back to me and  an address in Hawick.  I immediately said that was not my address and asked was there a possibly of two people with the same name.  The receptionist still puzzled, asked me to confirm my date of birth and address to which he replied the other lady was almost twenty years older.  I asked had we both been booked in for 1.30pm to which there was a hesitation and then a yes, we were both there for one appointment.  I showed the email from Dr Tyagi and his receptionist confirming my appointment. We had a seat in the main reception, then the receptionist appeared and said there was a lady sitting in the waiting room for an appointment that was not needed.  We were then taken to a waiting room.  I looked around to see if I could see the "other me twenty years older"  As the time was going on I realised that the other lady was obviously in seeing Dr T.  Eventually she emerged and I heard reception chatting to her and apologising.


When I was called for by the nurse for my appointment it had gone 2pm.  Dr Tyagi started off by explaining the error and that he was partly to blame and so was his secretary and that the other lady had been sent a letter for todays appointment.  Dr T then carried on with the appointment and asked me to explain my symptoms, he went into my file on the computer then quickly closed it again saying  "I will get that sorted" Mr Wanderer and I seen the other ladies letter in my file which was obviously the letter that was meant for me.  I was slightly annoyed that I had to explain my symptoms again as I had given them on every occasion I'd seen him and I had also typed them up and given a paper copy to him, anyway at least he would maybe remember this time.  I still had an underlying feeling he doesn't really remember me or my case.  I decided not to be a difficult patient and proceeded to list all my symptoms again which he typed into his computer.  Dr T then began to explain had I hypothetically had a dissection what the treatment would have been and that it would of entailed six months of anticoagulants or aspirin.  I questioned everything he stated and said that hypothetically had I of had a dissection that healed without causing a false lumen then that might of been the case yet here I was clearly suffering on going symptoms of dissection because of the false lumen pressing on adjacent structures causing nerve damage.  I continued and questioned the scans because I had reports from other doctors around the world that said my Mra was abnormal and how did that compare to my CTA.  Dr T confirmed that my MRA & CTA were normal and were marked normal. I was getting annoyed and upset at this point because as I explained to him I could see that the artery is not normal and I have over 200 scan images showing same.  Dr T decided that an Mra can pick things up and highlight them when there is actually nothing there, he mentioned fat saturation on the scan but I had to remind him that that technique was not actually used on my scans.  Therefor what he was stating didn't apply.  I mentioned about the MRA being marked normal and how was it possible that I had reports from other doctor's on my Mra that state they can see evidence of a vertebral artery dissection. I asked did the CTA show a false lumen or a double channel in my artery and he replied the lumen was normal and patent.  I asked how this was possible and he replied that "an Mra can have movement and show a high signal" but then he back tracked and said "not that there was any movement in your scan".  I reminded him that I still had no letter of my result and that I had emailed him on more than one occasion asking for it as well as a copy on disc of the CTA, he said he would get a copy of the CTA for me. He absolutely refuted that I had a dissection and had it been one they would not operate to get rid of the false lumen as I had mentioned that the doctor in New York had suggested how to fix the artery in his report.  I asked again that I wanted a copy of my CTA scan and report to get an opinion on it, again he said it was not a problem, that I was entitled to do so.  When I got upset Mr Wanderer spoke and gave his opinion it was only then that Dr T offered three options after saying what did I want them to do.  I was blunt and said I wanted a diagnosis and wanted to be treated to stop the symptoms, I said surely after suffering over two and a half years I was entitled to find out what was causing all these problems, he sat nodding saying "sure, sure"  He then offered a drug infusion to try and take the headache away, which I agreed immediately to. I am now awaiting that appointment to go into hospital and have it done, the other option was to repeat the scans yet he said there was little point in doing so. The last option was an Occipital nerve block injection which I reminded him that he had already sent me for last November that didn't work.  I feel he only offered up the options because he felt he needed to be seen as doing something because I was upset.  Why could the drug infusion not have been offered last year? 






Thanks for reading the never ending VertebralGate
Whirring Wanderer