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

January 2015 It is not all in my head!!!

Still suffering and still searching for answers.  I found a Neurointerventialist in New York by googling and reading reviews. The Whooshers.com website that I have visited often also had good things to say about him and many patients in New York and beyond have reached out to him and been treated successfully.  Whooshers website is an interesting read, I found the web site by typing in wooshing and headache.  I made contact with Dr Shapiro of Langone Medical Centre in December and sent my Mra/Mrv on disc by post on the 2nd January.





7th January I was expected to be at a Pain Clinic appointment for another Occipital Nerve injection but I forgot about it and I'm ashamed to say I forgot to cancel it. Dr Meiklejohn will think I am extremely rude. The truth is I am extremely exhausted and can't function properly and do not want to keep going to numerous appointments when doctors have no interest in helping me.  I have lost all trust in them, I feel like I'm a burden to them and a hypochondriac.



On the 19th January my doctor surgery called to state a prescription had been written for me by the doctor and is waiting to be collected.  I have yet to collect it as I am unsure about taking it when I still don't know what is wrong with me. I have waited since the 12th December for the new prescription and I'm sure I can wait a bit longer until the Neurointerventionalist has had a look at my scans, then if nothing is found I will take the new prescription.



TUESDAY 27TH JAN 2015 DIAGNOSIS

I emailed the Neurointerventionalist Dr Shapiro in New York for a timescale of when he is able to view my scans.  In the evening he called, I wasn't going to answer the phone as it was showing "outside area" and normally it's marketing calls. Dr Shapiro had emailed me a few images and asked that I switch on my computer to talk through the images. The phone call lasted 45 minutes.  Diagnosis; A possible fenestration of the vertebral artery or a Vertebral Artery Dissection (VAD) that has healed separating the artery into two separate channels. The fenestration would cause no clinical symptoms however a vertebral artery dissection would cause all of my symptoms. This all makes sense when I read the symptoms of a VAD and then compare to my own suffering.  I believe when my wooshing baby ultrasound noise changed to a whirr is when the artery was healing to form the two channels.  I was actually hearing turbulent blood flow!!! I knew there was something wrong, there had to be, I am not imagining all these symptoms.  Dr Shapiro suggests a cerebral angiogram to confirm his diagnosis and a balloon occlusion test which would close off the artery to see if it stopped the sound in my head and if so a stent could be placed to help with my symptoms.



WEDNESDAY 28TH JANUARY

I walked and partly staggered 2.2miles to my GP surgery to see Dr Stevenson.  I explained I had sent my scans to New York and showed him the images I had been sent from the Neurointerventionalist. The doctor showed a little uneasiness in his seat and stated he wasn't an expert on these type of things and to move forward he would need a report so that it could be sent back to the radiographer at the private hospital where I had the scan carried out.  I explained I would not be paying for any treatment or appointments under private care but the doctor explained it had to be referred back there for another opinion.  It was very much a pass the buck attitude.  Dr St. gave me the GP surgeries email address to forward the report.  I emailed the Neurointerventionalist and asked if he would kindly write a report of his findings for my doctor so they could act on it.  Thankfully just two hours later he did and I forwarded it my doctor and to the Neurologist Dr Tyagi.



THURSDAY 29TH JANUARY 3.40pm

My GP surgery called to say the doctor had read the report and that an urgent referral had been arranged to Neurology.  I asked if I would be contacted by letter or telephone which was confirmed that I would receive an appointment by letter.


It looks like my journey on the NHS roller-coaster is not over just yet.





All for now
Whooshing Wanderer