@aaronh819 I just found this post today on facebook from the physical therapist from the link I posted for you about migraines and vision problems. If you go to the facebook post link, there are MRI scans of compression of the jugular vein. This is detailed information for educational purposes by a physical therapist.

(**Comment edited* The Training and Rehabilitation facebook page no longer exists because they have changed their name to https://www.facebook.com/mskneurology1 and their new website is https://mskneurology.com/. This quoted text below was from the old facebook page under the old name. **)

Here is the text:

"35-year-old nurse visits my clinic after soon 8 years of chronic pain and disability. The main problem is severe, chronic vertigo, and blurred vision. She suffered sudden syncope after performing CPR (on a patient) in her ward, i.e. during work, and was never the same after that. Had cerebral MRI which was "normal", ECG had slight findings, but not enough to be significant. Ophthalmologist claims the eyes are normal. Two months after this incidence she was unable to keep working, as she literally had to hold onto the walls when walking in the hallways of her hospital ward, due to persistent vertigo. Loading of the arms quickly exacerbate the symptoms to the degree of debilitation. Also has a history of whiplash in 2003, chronic neck pain and frequent migraines prior to this incidence.

Examination of her MRI, not shockingly, reveals obstruction of the bilateral internal jugular veins. There is slight concavity of the pituitary gland, and oval appearance of the eyes. Further, there is a significant dilation of the optic nerve sheaths bilaterally, but most pronounced on her worst side. A systematic review and meta-analysis shows that optic nerve sheath distention (ONSD) above 5,7mm has 80% specificity for CSF pressures above 20mm Hg (26cm h2o) (Geeraerts 2008). Thus, there are many indications of intracranial hypertension.

Ultrasound: I was able to demonstrate papilledema bilaterally as well as high ONSD also here (images aren't the best). Further, only 380ml/min total venous drainage via the internal jugular, which is less than normal (550-900ml/min - Schreiber 1985), and consistent with the obstruction demonstrable on MRI. There was only 35ml/min on the left side, consistent with severe obstruction (Özen 2014), and intracranial hypertension. There were also blunted systolic pressures in the brachial arteries.

This patient, unfortunately, has lots of problems. Craniovascular hypertension explains her chronic dizziness, migraine, fatigue and ocular pain. Extended upper cervical postures may cause obstruction of the IJVs (Seoane 1999), and we are now working on changing this. She also has thoracic outlet syndrome (blunted brachial systolic pressures, positive Morley's test, pronounced weakness of the arm), which we have begun treating as well. This patient now has a lot of hard work ahead of her, but I think that we will be able to improve the situation, as no permanent damage seems to be inflicted."