Acute vertebrobasilar insufficiency. Vertebrobasilar insufficiency: causes, symptoms and treatment of VBI

The vertebral artery is located at the back of the spine and merges with the vertebral artery of the opposite side to form the basilar artery. These arteries supply blood, oxygen, and nutrients to vital brain structures such as the brainstem, occipital lobes, and cerebellum. Circulatory disorder in the above pool is called - vertebrobasilar insufficiency.

A condition called atherosclerosis reduces or stops the flow of blood through the vertebrobasilar system. Atherosclerosis is characterized by narrowing and blockage of the arteries due to the deposition of cholesterol in them. More on this: plaque, which consists of cholesterol and calcium, accumulates in your arteries, narrowing their lumen, cholesterol plaques form, and as a result, blood flow to the brain decreases. Cholesterol plaques can completely block the blood flow in the arteries, causing their absolute stenosis, which can cause a stroke. This can happen in any artery in your body. When this happens in the arteries of your vertebrobasilar system, it reduces blood flow to the structures at the back of your brain. This condition is known as vertebrobasilar insufficiency (VBI).

What causes VBN?

Vertebrobasilar insufficiency syndrome occurs when blood flow to the back of your brain is reduced or stopped. It is known that atherosclerosis is the most common cause diseases. In turn, an important etiological role is played by cervical osteochondrosis, the developmental features of the blood vessels of the vertebrobasilar basin: aplasia and hypoplasia of the vertebral arteries or the basilar artery, their pathological course (tortuosity).

Who is at risk of acquiring vertebrobasilar insufficiency syndrome?

Risk factors for the development of VBN are similar to those associated with the development of atherosclerosis. These include:

smoking
high blood pressure (hypertension)
diabetes
obesity
age over 50
family history
elevated blood lipids (known as hyperlipidemia, dyslipidemia)

People who suffer from atherosclerosis or diseases peripheral arteries also have an increased risk of developing vertebrobasilar insufficiency.

What are the symptoms of vertebrobasilar insufficiency?

Symptoms vary depending on the severity of the condition. Some symptoms may last for several minutes and some may become permanent. Common symptoms of vertebrobasilar insufficiency include:

Loss or impairment of vision in one or both eyes
Double vision
dizziness (vertigo)
numbness or tingling in the hands or legs
nausea and vomiting
slurred speech
mental status changes, including sometimes confusion
sudden, severe weakness throughout the body, called a drop attack
loss of balance and coordination of movements
difficulty swallowing
weakness in any limb

Symptoms of acute vertebrobasilar insufficiency similar to a stroke. Apply for an emergency medical care if you are experiencing these symptoms. Immediate medical intervention will help increase your chances of recovery if these symptoms are the result of a stroke.

VBN diagnosis?

Your doctor will perform an objective neurological exam, ask you about your chronic medical conditions, and may, in some cases, prescribe:

CT or MRI, BCS duplex scanning
magnetic resonance angiography (MRA)
blood test, coagulogram
echocardiography
in rare cases, a hospital doctor may also order a lumbar puncture.

The leading role in the diagnosis of NCC in the VBB is currently MRI and CT as well. When diagnosing vertebrobasilar insufficiency, it must be taken into account that the symptoms of the disease are often not specific and may be the result of another neurological or other pathology, which requires careful collection of the patient's sting, study of the history of the disease, physical and instrumental examinations to identify the root cause.

Distinguish USDG of vessels of the brain and ultrasound of the vessels of the neck. Often they are carried out together, this creates a holistic view of the vessels supplying the brain with blood. The technique includes the study of carotid arteries, subclavian and vertebral arteries, neck veins, as well as the main arteries of the brain.

An image in ultrasound examinations of the vessels of the head and neck is obtained due to the fact that ultrasonic waves emitted by special ultrasonic sensors, passing through a blood vessel, are reflected differently from erythrocyte cells, depending on the direction and speed of blood flow. The reflected waves are captured by an ultrasonic transducer and, after being converted into electrical impulses, are displayed on a monitor in real time in the form of graphs and color photographs that represent the flow of blood through the blood vessels. Ultrasound of blood vessels allows you to see in real time the vessels "from the inside" and "outside", thereby making it possible to determine changes in blood flow in the vessels associated with spasm, narrowing or thrombosis.

During dopplerography it is possible to study only one function - the patency of the vessel, to clarify the degree of occlusion in%, in addition, ultrasonic duplex scanning of blood vessels (USDS), allows you to simultaneously evaluate two functions - to examine the structure of blood vessels and assess the speed of blood flow, and ultrasonic triplex scanning– study of three functions:

study of the structure of blood vessels;
evaluate blood flow
accurate assessment of vascular patency in color mode.

Magnetic resonance angiography - MRA

MRA or magnetic resonance angiography is an informative and safe method radiodiagnosis, which does not use X-rays, allows you to make a 3-D picture of the vascular bed of the brain.

This study allows you to timely prescribe the appropriate treatment and, thereby, improve the prognosis of the course of the disease; also, based on the MRA data, you can conduct a preoperative examination in case of stenting or angioplasty.
MR angiography is used to diagnose:

aneurysms and pathological anastomoses;
stenosis and occlusion of blood vessels;
vascular malformations;
atherosclerotic changes in the arteries of the neck and brain.

MR angiography of the arteries of the brain is performed without contrast - this is an undeniable advantage.

To clarify the level and degree of damage to the auditory tract, a study of auditory evoked potentials is prescribed. Consultations of an ENT, audiologist, an audiogram are prescribed for the purpose of a differential diagnosis.
MRI cervical spine for the purpose of vertebrogenic effects on the vertebral artery.

Treatment of vertebrobasilar insufficiency

quit smoking if you smoke
dietary changes to control blood cholesterol levels
weight loss if you are overweight or obese
more active lifestyle, exercise therapy

In addition, your doctor may prescribe medications to help reduce the risk of stroke, the severity of the effects of chronic cerebral ischemia in TBB. If there is stenosing atherosclerosis of the arteries of the head, a high probability of thrombosis or embolism, the risk of recurrent stroke in patients who have had a transient ischemic attack in the VBB, preventive measures are applied that eliminate the existing risk factors.

These drugs are aimed at:
blood sugar control
lowering blood cholesterol levels
improved blood circulation
decrease in blood clotting

In case of an acute neurological deficit - alternating syndromes, cerebellar insufficiency, negative scotomas, the patient should be urgently hospitalized in the vascular center of the neurological department to exclude a stroke in the VBB.

According to the most effective drugs for secondary prevention of ischemic stroke:

acetylsalicylic acid
dipyridamole
iclopidine
chimes
clopidogrel.

Aspirin at a dose of 75–150 mg/day remains the gold standard for stroke prevention to date.

Chronic vertebrobasilar insufficiency is often accompanied by elevated cholesterol levels and (or) dyslipidemia; atherosclerosis of the basilar or vertebral arteries may occur. In this situation, taking into account the level of cholesterol, % stenosis of the arteries of the vertebrobasilar basin and carotid arteries, comorbidity, the question of the need to prescribe statins, for example, atorvastatin at a dose of 10 mg / day, may be raised. LDL at 1.0 mmol / l leads to a reduction in the risk of all strokes by 10%, and at 1.8 mmol / l - by 17%. In general, according to a number of studies, the use of statins for 3-5 years can reduce the risk of stroke by 24-36% in chronic VBI.
Therapeutic exercise and moderate exercise significantly reduce the risk cardiovascular diseases and stroke, it is statistically noted that people with moderate or high activity have a lower incidence of stroke compared to people suffering from state of hypodynamia. Moreover, moderate physical activity reduces the risk in men and women by 20%, high physical activity - by 27%. This is due to the fact that a tendency to reduce blood pressure and body weight is formed, blood vessels expand, and glucose tolerance improves.

Correction of oxidative stress and neurometabolic therapy in VBI

Treatment of vertebrobasilar insufficiency with mexidol. Mexidol consists of two related and functionally significant compounds: 2-ethyl-b-methyl-3-hydroxypyridine and succinic acid. The presence of 3-hydroxypyridine in the structure of mexidol provides a complex of its antioxidant and membranotropic effects, the ability to reduce glutamate cytotoxicity, regulate the functioning of receptors, which fundamentally distinguishes mexidol from other drugs containing succinic acid.
The presence of succinate in the structure of mexidol distinguishes it from emoxipin and other 3-hydroxypyridine derivatives, since succinate is functionally significant for many processes occurring in the body and, in particular, is a substrate for increasing energy metabolism in the cell. The combination of two compounds with the necessary properties in the structure of Mexidol ensures its good permeability through the blood-brain barrier, high availability and impact on various targets, which results in a wide range of drug effects and high therapeutic potential. Mexidol is prescribed 500 mg / day parenterally for 2 weeks, followed by a switch to a tablet company of 125-250 mg (1-2 tablets) 3 times a day for at least 1 month. In addition, the neurometabolic drugs gliatilin, neuromidin, combilipen are used.

The antihypoxic drug Cytoflavin is used

On the background complex treatment patients with vertebrobasilar insufficiency using cytoflavin showed positive dynamics clinical symptoms: dizziness, visual disturbances, cephalic syndrome. It is characterized by accelerated rates of normalization in comparison with traditional methods of therapy. Cytoflavin has a regulatory effect on
peripheral circulatory resistance in the vertebral arteries, vasomotor reactivity in the basilar artery, which indicates an improvement in cerebrovascular reactivity and an increase in the compensatory possibilities of blood flow in the VBB pool.

Significant correction of blood pressure, antiplatelet therapy for various cardiac arrhythmias.

Surgical treatment of vertebrobasilar insufficiency

In some cases, the doctor may recommend a consultation with an angiosurgeon, who may prescribe surgery to restore blood flow to the back of the brain. Bypass or endarterectomy as options. Endarterectomy is the removal of an atherosclerotic plaque from an affected artery.

With stenosing cerebral atherosclerosis, in the case of critical arterial stenoses, the following surgical interventions are performed:

angioplasty of the corresponding vessels
stenting of the corresponding vessels
endarterectomy
imposition of extracranial and intracranial anastomoses.

VBI prevention?

Sometimes a disease cannot be prevented. This may be in older people who have had a previous stroke. However, there are measures that reduce the development of atherosclerosis and VBI.

These include:

to give up smoking
blood pressure control
control blood sugar levels
eating a healthy diet that is rich in fruits, vegetables, and whole grains
physical activity

What is the long-term outlook for the disease?

The prognosis depends on your current symptoms, medical condition, and age. Younger patients who experience mild symptoms of vertebrobasilar insufficiency can be controlled with lifestyle changes and drug therapy tend to have a good prognosis. old age, a weakened body, and chronic concomitant diseases can adversely affect the course of the pathological process. Discuss treatment options and medications with your doctor to help prevent or reduce symptoms of NDV.

Content

A disease such as ischemic stroke of the brain is main reason disability today. Pathology has a high mortality, and in surviving patients causes severe consequences of the cerebrovascular type. There are various reasons for the development of the disease.

What is vertebrobasilar insufficiency

The spinal arteries exit subclavian vessels located in the upper part of the sternum cavity and pass through the openings of the transverse processes of the vertebrae of the neck. Further, the branches go through the cranial cavity, where they join into one basilar artery. It is located at the bottom brain stem and provides blood supply to the cerebellum and the occipital region of both hemispheres. Vertebrobasilar syndrome is a condition characterized by a reduction in blood flow in the vertebral and basilar vessels.

Pathology is a reversible violation of brain functions, which occurred as a result of a decrease in the blood supply to the area fed by the main artery and vertebral vessels. According to ICD 10, the disease is called "syndrome of vertebrobasilar insufficiency" and, depending on concomitant disorders, it may have the code P82 or H81. Since the manifestations of VBI can be different, the clinical symptoms are similar to other diseases, due to the complexity of diagnosing pathology, the doctor often makes a diagnosis without proper justification.

Causes of ischemic stroke

Factors that can cause ischemic stroke in the vertebrobasilar basin include:

Embolism of various origins in the vertebrobasilar region or compression of the subclavian artery.
An arrhythmia in which thrombosis develops in the atria or other parts of the heart. At any moment, blood clots can break into pieces and enter the vascular system along with the blood, causing blockage of the arteries of the brain.
Atherosclerosis. The disease is characterized by the deposition of cholesterol fractions in the arterial walls. As a result, the lumen of the vessel narrows, which leads to a decrease in blood circulation in the brain. In addition, there is a risk that the atherosclerotic plaque will crack, and the cholesterol released from it will block the artery in the brain.
Presence in vessels lower extremities blood clots. They can be divided into segments and, together with the bloodstream, enter the cerebral arteries. Causing difficulty in the blood supply to the organ, blood clots lead to a stroke.
A sharp decrease in blood pressure or hypertensive crisis.
Clamping of the arteries supplying blood to the brain. This can happen during surgery carotid artery.
A strong thickening of the blood caused by the growth of blood cells leads to difficulty in the patency of blood vessels.

Signs of a cerebral infarction

The disease is an acute violation of cerebral blood supply (stroke of the ischemic type) with the subsequent development of signs of a neurological disease that persist for up to a day. In transient ischemic attacks, the patient:

temporarily loses sight;
loses sensation in any half of the body;
feels stiffness in the movements of the arms and / or legs.

Symptoms of vertebrobasilar insufficiency

Ischemic stroke of the brain with localization in the vertebrobasilar basin is perhaps the most common cause of disability in people under 60 years of age. The symptoms of the disease differ and depend on the localization of the violation of the main functions of the vessels. If blood circulation has been disturbed in the vertebrobasilar basin, the patient develops the following characteristic symptoms:

dizziness of a systemic nature (the patient feels as if everything around him is collapsing);
chaotic movement eyeballs or its restriction (in severe cases, complete immobility of the eyes occurs, strabismus is formed);
deterioration in coordination;
tremor during the performance of any action (trembling of the limbs);
paralysis of the body or its individual parts;
nystagmus of the eyeballs;
loss of body sensitivity (usually occurs in one half - left, right, bottom or top);
sudden loss of consciousness;
irregular breathing, significant pauses between inhalations / exhalations.

Prevention

The human cardiovascular system is constantly under stress as a result of stress, so the risk of stroke increases. With age, the threat of thrombosis of the head vessels increases, so it is important to prevent coronary disease. To prevent vertebrobasilar insufficiency from developing, you should:

to refuse from bad habits;
with hypertension (high pressure), it is imperative to take medications to normalize blood pressure;
timely treat atherosclerotic stenosis, keep cholesterol levels normal;
eat a balanced diet, stick to a diet;
to control chronic diseases(diabetes mellitus, renal failure, arrhythmia);
often walk on the street, visit dispensaries and medical sanatoriums;
exercise regularly (exercise in moderation).

Treatment of vertebrobasilar syndrome

Therapy of the disease is prescribed after the doctor confirms the diagnosis. For the treatment of pathology are used:

antiplatelet agents, anticoagulants;
nootropics;
analgesics;
sedatives;
correctors of blood microcirculation;
angioprotectors;
histamine mimetics.

Ischemic brain disease is dangerous because seizures (strokes) gradually become more frequent, and as a result, an extensive violation of the blood circulation of the organ can occur. This leads to a complete loss of capacity. To prevent coronary disease from becoming severe, it is important to seek medical help in a timely manner. In the treatment of vertebrobasilar syndrome, the main actions are aimed at eliminating the problem with blood circulation. The main drugs that can be prescribed for ischemic disease:

acetylsalicylic acid;
Piracetam/Nootropil;
Clopidogrel or Agregal;
Troxerutin / Troxevasin.

Folk methods for the treatment of coronary disease can be used exclusively in the form additional measure. In case of ulceration of an atherosclerotic plaque or stenosis of the carotid artery, the doctor prescribes a resection of the affected area, followed by a shunt. After the operation, secondary prevention is carried out. For the treatment of VBS (vertebrobasilar syndrome), therapeutic exercises and other types of physiotherapy are also used.

Physiotherapy

Vertebrobasilar insufficiency cannot be cured with drugs alone. Along with drug treatment of the syndrome, therapeutic procedures are used:

massage of the occipital region;
magnetotherapy;
manual therapy;
physiotherapy to eliminate spasms;
strengthening the spinal trunk, improving posture;
acupuncture;
reflexology;
hirudotherapy;
use of a neck brace.

Treatment of cerebral ischemia

The most severe lesions in ischemic stroke that occurred in the vebrobasilar basin are brain stem injuries, since vital centers are located in it - respiratory, thermoregulatory, and others. Violation of the blood supply to this area leads to respiratory paralysis, collapse and other life-threatening consequences. Ischemic stroke in the vebrobasilar basin is treated by restoring impaired cerebral circulation and eliminating inflammatory foci.

A stroke of the brain is a disease that is treated by a neurologist in a hospital setting. For therapeutic purposes, in ischemic stroke of the vertebrobasilar basin, a drug method is used. During the treatment period, the following drugs are used:

vasodilators to relieve spasms (nicotinic acid, Pentoxifylline);
angioprotectors that stimulate cerebral circulation, metabolism (Nimodipine, Bilobil);
antiplatelet agents to prevent thrombosis (Aspirin, Dipyridamole);
nootropics for revitalization brain activity(Piracetam, Cerebosin).

Drug treatment of ischemic stroke, which occurred in the vertebrobasilar basin, lasts for 2 years. In addition, an operative method of treating the disease can be used. Surgical intervention for vertebrobasilar syndrome is indicated for the third degree coronary disease if conservative treatment did not give the expected effect.

According to ongoing studies, severe consequences of ischemic stroke that occurred in the vertebrobasilar basin occur in two cases. This happens if the treatment was not started in a timely manner or did not give results in the later stages of the development of the disease. In this case, a negative outcome of vertebrobasilar insufficiency can be:

mental retardation;
isolation;
asociality;
difficulty in learning;
migraine.

First aid for stroke

If you see symptoms of ischemic stroke in a person, call ambulance. Describe the symptoms to the dispatcher as accurately as possible so that the neurological team arrives on call. Next, give the patient first aid:

Help the person to lie down. At the same time, turn it on its side, under lower jaw substitute any wide container in case of vomiting.
Measure BP. With an ischemic stroke that occurred in the vertebrobasilar basin, the pressure is usually elevated (about 180/110).
Give the patient an antihypertensive agent (Corinfar, Captopril, others). In this case, it is better to put 1 tablet under the tongue - this way the remedy will work faster.
Give a person with a suspected ischemic stroke 2 diuretic tablets. This will help relieve swelling of the brain.
To improve the metabolism of the patient's brain, give him a nootropic, for example, Glycine.
After the arrival of the ambulance team, tell the doctor exactly what drugs and at what dosage you gave to a patient with an ischemic stroke.

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Vertebrobasilar or vertebrobasilar insufficiency (abbreviation - VBN) is a pathological symptom complex of general or focal disorders of the functionality of the brain, which develops as a result of its inadequate blood supply to the basilar (main) and / or vertebral arteries.

In foreign countries, the term VBN is used to refer only to transient vascular insufficiency of brain tissues supplied with blood through the vertebrobasilar basin, while medicine in the post-Soviet space includes many more pathologies in this concept.

In particular, the domestic concept of VBN includes such painful conditions as:

vasotopic type ischemic transient attack ;
vertebrobasilar insufficiency against the background and other degenerative-dystrophic pathologies of the intervertebral discs;
chronic disorders of the blood supply to the parts of the brain that depend on the vertebrobasilar system;
accompanied by symptoms of VBI;
other diseases with vertebrobasilar insufficiency, the symptoms and treatment of which are similar to each other:, somatoform and , various genesis, etc.

Pathogenesis

The pathogenesis of VBI is based on a whole complex of macro- and microvasculature arteries that form the vertebrobasilar pool, supplying blood, and hence all nutrients, about 30% of all brain tissues and nearby structures spinal cord. The vertebrobasilar system itself is formed mainly from two vertebral arteries, which, at their confluence, pass into the basilar artery, and many smaller vascular branches. Thanks to it, the cerebellum, the posterior parts of the hypothalamus and thalamus, the pons varolii, the inner ear, the medulla oblongata and midbrain, some structures of the occipital and temporal cerebral lobes, as well as many segments of the spinal cord, are nourished.

In the case of a stenosing lesion of any part of this vascular system or its embolism, in other words, external compression of the arteries or their internal blockage, there is a decrease in the intensity of blood flow, which causes the development of VBI.

Depending on the severity of the damage to the arterial bed, there are several stages in the development of this pathology, namely:

compensation stage - the disease is asymptomatic or with the manifestation of minor focal neurological disorders;
stage of conditional compensation - may be manifested by the occurrence micro strokes , weak ischemic attacks , 1–2 discirculatory phase;
stage of decompensation - implies the development of the 3rd phase of the discirculatory and the presence of a completed episode with varying degrees of severity.

It should be remembered that VBI causes about a third of all detected cases, which in turn often lead to death.

Classification

AT clinical practice this pathology is classified in accordance with international standards, according to which it is assigned a code according to ICD-10 - G45.0 Syndrome of vertebrobasilar arterial system.

A classification can also be used that corresponds to the neurological picture of the disease, distinguishing 4 types of its course:

angiodistonic type - a variant of the course of the disease, in which clinical subjective symptoms prevail over manifestations of focal lesions of brain tissues;
ischemic type - a type of pathology, accompanied mainly by symptoms of ischemia in the region of the vertebrobasilar basin (vegetative-irritative manifestations are virtually absent);
angiodystonic-ischemic type - a variation of VBN, characterized by mixed symptoms;
type of residuals.

In addition, neuropathologists distinguish between chronic and acute vertebrobasilar insufficiency:

acute VBN - comes on suddenly due to sudden occlusion or other disorders of arterial blood flow (broken blood clot, hypertensive crisis, etc.) and lasts from several hours to one day;
chronic VBN - appears against the background of the absence of therapy for painful manifestations from the arterial system and is characterized by frequent or even constant negative symptoms.

The reasons

Modern neurology distinguishes many root causes of this pathology, which can be divided into congenital and acquired. Nevertheless, despite the variety of etiological factors, they all lead to the same type of negative manifestations, united under the term VBI.

Congenital causes of VBN

Among the congenital or hereditary causes of VBN, the following are distinguished:

anomalies in the formation of the fetus or its injuries that occurred during pregnancy or labor and led to violations of the corresponding part of the vascular or skeletal system (, multiple pregnancy , complex or etc.);
genetic pathologies of the structure of bone, muscle tissue or blood vessels in the neck (, tortuosity of arteries, additional ribs, arterial hypoplasia , kimmerley anomaly etc.).

Acquired causes of VBN

Acquired VBN develops against the background of various concomitant diseases, as well as life situations, as a result of which there is a violation of the circulatory process, damage to blood vessels and / or deformation of other tissues adjacent to the vertebrobasilar basin. The most common reasons for this are:

in the course of the main and / or vertebral arteries;
circulatory disorders against the background;
antiphospholipid syndrome ;
and soft tissues in the cervical region;
complications ;
pathology of the vascular walls ( arteritis );
Hughes-Stovin syndrome and those like him;
dissection of arteries vertebrobasilar system;
blood pathology.

Neurologists also note that some frequent or long-term head movements can also lead to the development of VBN. In particular, this applies to its strong turns in one direction or another and the maximum tipping back. By the way, on forums devoted to the problem of VBN, one can often find evidence of the onset of symptoms of this disease after sleeping in an uncomfortable position for the head.

Symptoms of vertebrobasilar insufficiency

According to one of the classifications, all symptoms of insufficiency in the arterial system of the vertebrobasilar basin are divided into acute (temporary) and chronic (permanent).

Acute symptoms

Short-term and at the same time severe symptoms of VBN accompanies the so-called vertebrobasilar crisis, which occurs during a transistor ischemic attack that sharply disrupts cerebral circulation and often leads to development in varying degrees of severity (up to death). Such intense negative manifestations, as a rule, last no longer than 24-48 hours, after which they gradually subside.

At the time of acute attacks of moderate VBI, a person may experience:

strong;
pressing pain in the back of the head;
discomfort in the neck.

With a more pronounced ischemic lesion of brain structures by the type of stroke, in addition to the above symptoms, the following may be noted:

fainting states;
limbs;
disorientation in time and space;
movement disorders;
visual and speech disorders;
sudden falls;
sensation numbness in the neck and face.

Chronic symptoms

Weaker persistent symptoms of VBN, the severity of which will depend on the stage of the pathology, a person may experience quite long time. In the absence of adequate therapy, the severity of these manifestations can increase, which will eventually lead to an acute condition and may result in disability and even death.

During the chronic development of VBI, the patient may notice:

frequent mood swings;
nausea ;
sensation of heat;
clouding of consciousness ;
throbbing, dull pain in the back of the head;
weakness ;
incoordination ;
memory impairment;
distraction;
irritability;
up to hoarseness of voice;
auditory and visual impairments.

Analyzes and diagnostics

In clinical practice, the diagnosis of vertebrobasilar syndrome is quite problematic, since the combination of negative symptoms of this pathology is far from unique. Similar symptoms are characteristic of many other diseases, and they appear in different people purely individually. In this regard, it can be quite difficult for a doctor to separate the true picture of the disease from the subjective perception of it by the patient himself.

Thus, making a correct diagnosis requires a neuropathologist to carefully study the anamnesis, collect detailed information about the course of the disease, and also conduct many analyzes, tests and instrumental studies. In addition, it is necessary not only to correctly diagnose the disease, but also to determine its root cause for each individual patient, since effective therapy must also include its treatment.

When diagnosing VBI, the following studies are indicated:

on its biochemical composition - allows you to track the functional ability internal organs and evaluate metabolism;
ultrasound dopplerography - a painless non-invasive technique that determines the condition of the vessels in the required area and their throughput in relation to blood;
spinal x-ray - helps to identify the possible presence of traumatic or other pathological injuries in the cervical region;
rheoencephalography - examines the degree of blood supply to the brain tissues;
CT and MRI research - more clearly recognize spinal problems, including, Kimmerley anomaly and other similar painful conditions;
digital subtraction angiography - a method for examining the patency of the vascular bed with the help of an injected contrast agent;
functional tests of the "flexion-extension" type - a test for a possible displacement of the vertebrae ();
infrared thermography – gives an assessment of the condition of certain areas human body, consistent with their thermal fields;
neuropsychological testing - reveals the cognitive functionality of the brain;
auscultation of vessels – the procedure of physical listening of arterial noises;
oto neurological examination- determines the extent of damage to the vestibular system;
hyperventilation tests - detect violations in the mode of operation of cardio-vascular system.

Differential Diagnosis

Such a pathology as VBN must be differentiated from other diseases with similar negative symptoms, since all further therapeutic tactics for managing the patient will depend on this. Most often, inexperienced doctors can confuse the painful manifestations of VBI with diseases such as:

various disorders in the mental sphere;
neuroma (benign formation) of the auditory nerve;
vestibular neuronitis (lesion of the vestibular apparatus);
Meniere's syndrome (increased level of labyrinth fluid in the inner ear);
acute labyrinthitis (defect of the receptors of the nerve endings of the inner ear).

A distinctive feature of all these and many other pathologies are the same type of painful manifestations, but in fact they have nothing to do with VBI. For example, when multiple sclerosis attacks of dizziness in the patient are longer, and hearing impairment are completely absent. At Meniere's syndrome dizziness in a patient is very similar to similar phenomena of VBN, but at the same time his vascular system is not subject to changes, etc.

Treatment of vertebrobasilar insufficiency

After diagnosing VBN in a person, a neuropathologist should prescribe the most adequate therapy for him, which will also affect the disease that caused this situation. Due to the diversity of the causes of this pathology, in principle, there is no general scheme for its treatment; therapeutic tactics are selected for each patient strictly individually. With mild symptoms, it is permissible to correct the patient's condition on an outpatient basis, and in the case of a severe course of the disease, he should be redirected to a hospital in order to avoid serious complications (stroke).

As a rule, with VBI, an integrated approach to treatment is used, including both drug therapy and physiotherapy. It should also be remembered that in some forms of VBI, the drugs used may be ineffective. In this case, the doctor needs to pay close attention to the underlying cause of the disease or consider surgery.

The first step on the path to recovery, which consists in changing your lifestyle, must be taken by the patient himself, who must:

keep yourself in shape by practicing feasible physical activity;
control your own arterial pressure and serum glucose concentration;
adhere to a certain diet rich in seafood, vegetables and fruits and limiting the intake of salt, flour, smoked meats and other potentially harmful foods;
reduce body weight (if necessary).

The doctors

Medications

As stated earlier, drug therapy for each patient is selected individually, depending on the observed symptoms and the underlying disease. Consistent with this, the doctor may include the following in the treatment regimen: medicines:

vasoactive agents (,) - favor the expansion of blood vessels and improve blood circulation in the nervous tissues;
antihypoxants and antioxidants ( , ) - reduce the manifestations of hypoxia;
vestibulotropic drugs (,) - restore the vestibular apparatus;
diuretics ( , epletor , ) - exhibit diuretic properties;
anticoagulants ( , ) - strengthen vascular walls, improve microcirculation and prevent thrombosis;
antihypertensive drugs from different groups ( , ) - correct and / or restore blood pressure;
nootropic drugs ( Neuroxon , ) - improve brain activity and functionality;
antispasmodics (, ) - prevent vasospasm;
antiemetics ( , );
analgesics ( , Bol Run , ).

In addition to the above medicines, a neuropathologist can prescribe any other therapeutic agents that help relieve the observed negative symptoms or treat the underlying disease.

Procedures and operations

Physiotherapy

In combination with the use of the necessary medications, the doctor may prescribe one or more physiotherapy procedures to the patient with VBI, among which the most commonly used are:

in the form of a massage that improves blood circulation in the cervical region;
(treatment with leeches);
aimed at relieving muscle spasms;
helping to relieve pain and reduce the severity of dizziness;
neck corset , which prevents physical squeezing of the arteries in the neck area;
therapeutic gymnastics that strengthens the muscles of the spine and improves posture.

The last physiotherapy is considered the most effective for VBN, however, certain gymnastic exercises can be performed only with the permission of the attending physician, since some of them will be contraindicated for certain underlying diseases (for example, with). In addition, therapeutic exercises should be regular, carried out in mild form, without sudden movements and special efforts. It is best to do it in the morning, choosing a leisurely pace and watching your own breathing (you need to breathe through your nose, deeply and evenly). After the end of the set of exercises, it will be useful to have a relaxing massage and a contrast shower.

Depending on the picture of the course of VBN, the neuropathologist may recommend the following gymnastic exercises to the patient:

With your body upright, put your toes together and tilt your head forward, touching your chin to your upper chest. Stay in this position for a few seconds, then return to the starting position (10 sets).
In the same position of the body, gradually tilt your head to the right and left side, trying to reach your collarbone with your ear (do not raise your shoulders). As in the previous case, stay in this position for a few seconds, then return to the starting position (10 sets).
Standing or sitting, do 10 rotations of the head clockwise, and after 10 rotations of the head counterclockwise.
Stretch your head with the top of your head up, fix it in this position for a few seconds and relax (10 sets).
Slowly pull your head forward, and then also slowly return it to its original position.
Stand up straight with your arms at your sides and slowly raise them until your palms touch. Wait a few seconds and slowly lower your arms (10 sets).
Turn your head to the right and left, briefly fixing it in the extreme position (10 sets).
Standing on the floor, alternately raise and lower both legs, leaving them in the upper position for 5 seconds (10 sets).
Stand 30 centimeters from the door and rest your palms on the doorway at shoulder level. Do 15 pushups.
Stand on one, and then on the other leg as long as possible. If this is not difficult, try doing it with your eyes closed.
With good general health and physical fitness, try to make low jumps to the right and left with body rotation around its axis (10 approaches).

Surgery

In the absence of a positive effect from the use drug treatment and physiotherapy, the patient may be recommended surgical intervention, the purpose of which is to improve blood circulation in the vertebrobasilar basin by removing the agent that compresses the vessels or cleansing the lumen of the corresponding arteries.

With VBN, the following operations are most often performed:

angioplasty - intervention in the damaged artery with the implantation of a special stent into its lumen, which prevents the narrowing of the arterial walls and restores normal blood circulation;
endarterectomy – surgical technique, allowing you to remove atherosclerotic plaques from the inner walls of the artery, thereby resuming the natural circulation of blood;
microdiscectomy - neurosurgical micro-operation to remove, squeezing blood vessels and impeding blood flow.

Treatment with folk remedies

If traditional medicine is used in the treatment of VBN, you should first consult with your doctor and use it only as an addition to the main treatment. To reduce certain negative symptoms this disease and enhance the action of essential drugs, you can resort to the help of such herbal remedies.

Anticoagulants

Berries and fruits containing a large number of vitamin C. With VBN, it is especially recommended to use: rose hips, lemons, cranberries, kiwi, viburnum, oranges, sea buckthorn, currants and other products with a similar composition.

Horse chestnut, on the basis of which many preparations of official medicine have been created, also helps to reduce blood clotting. In order to prepare such a remedy at home, wipe 0.5 kilograms of unpeeled chestnut seeds, pour them with 1.5 liters of vodka and leave in a dark place for 7 days. After that, you need to strain the finished tincture and take it three times a day 30 minutes before a meal, 1 tsp.

Another effective means of such an action in traditional medicine considered garlic. For example, you can prepare such an extract from it. Pass 3 large heads of garlic through a meat grinder, transfer this mass to a glass jar and keep it in the refrigerator for 2-3 days. Then add an amount of honey and lemon juice similar to garlic to the jar and mix everything thoroughly. Continue to store the garlic extract in the refrigerator and consume it at bedtime, 1 tbsp. l.

Vasodilators

In terms of vasodilation, hawthorn infusion, used three times a day for 1 tbsp, has proven itself well. l. half an hour before meals. To prepare it, it is necessary to pour 20 g of hawthorn fruits with a glass of boiling water, hold them for 5 minutes in a water bath, and then leave for about 30 minutes more.

In turn, a herbal mixture of chamomile, birch buds, St. John's wort, immortelle and yarrow has a vasodilating effect. All these plants should be mixed in equal proportions and placed in a jar with a tight-fitting lid. Every next day for a month you need to brew 1 tbsp. l. of this mixture with boiling water in a volume of 0.5 liters and drink in the morning and evening 30 minutes before meals, 250 ml each.

Antihypertensive agents

A decoction of mint, fragrant rue, valerian and corn stigmas, mixed in equal parts, will help normalize blood pressure. As in the previous case, 1 tbsp. l. a similar mixture should be brewed daily with a glass of boiling water, insist for 30 minutes and drink 1/3 cup three times a day for a month before meals.

A tincture of 40 g of corn stigmas, 20 g of lemon balm and the juice of one whole lemon also has a positive effect on blood pressure. This mixture should be poured with a liter of boiling water, insisted for an hour and drunk 200 ml 3 times a day after meals. You can continuously use this tincture for a week, after which you need to take a 7-day break. The general course of such treatment is 3 weeks at proportional intervals.

First aid

If an acute attack of VBN is suspected, the patient's relatives need to put him to bed, ensure fresh air enters the room and urgently call an ambulance. In this case, it is not recommended to use any therapeutic agents without the recommendation of a doctor.

Prevention

To prevent the occurrence of manifestations of the vertebrobasilar syndrome, a person predisposed to the development of such pathologies should adhere to certain rules, namely:

to practice proper nutrition by limiting the intake of salt in the first place;
engage in feasible physical education;
to be in the air more often;
avoid and ;
give up all bad habits;
to control ;
create comfortable working and sleeping conditions (in terms of body position);
periodically undergo an examination by a neurologist.

In order to prevent relapse after an attack of VBI, the patient must follow all the above recommendations, as well as follow preventive therapy (antihypertensive, anticoagulant, antiplatelet, etc.) prescribed at the stage of hospitalization.

In children

In the past few decades, doctors have noted a sharp increase in the incidence of VBN in the younger generation, including even children 3-5 years old. As a rule, this pathology occurs due to the presence of congenital vascular and bone anomalies in the region of the vertebrobasilar basin, as well as due to the received weak spine, but it can often be the result of other concomitant diseases (for example,).

Some of the specific signs of this pathology in children below will help parents determine its possible formation in their child, after which they should immediately consult their pediatrician. In most cases, VBI in children is mild and can be quickly corrected with minor medication and manual therapy, but nevertheless sometimes requires surgical intervention. With the timely diagnosis of this disease and its further proper treatment, the prognosis for children and adolescents will be as favorable as possible.

Symptoms of VBN in childhood most often manifested:

violation of posture;
weather dependence;
elevated fatigue and ;
frequent, which may be accompanied by vomiting;
bouts of bad mood and crying;
pain in the neck and neck;
intolerance to stuffiness;
irritability and whims ;
inattention and poor learning;
fainting .

Consequences and complications

With late diagnosis of VBN and the lack of adequate treatment, this disease can be complicated chronic course or an acute attack, which can lead to serious consequences, such as:

permanent ischemic attacks ;
formation;
development ;
irreversible brain damage;
fatal outcome.

Forecast

A positive prognosis of the course of VBI is possible only with early detection of the disease and the appointment of its correct treatment. In this case, the patient is obliged to begin therapy immediately after diagnosing the problem and strictly adhere to absolutely all the prescriptions of a qualified doctor. Otherwise, VBN will progress and, most likely, will cause the severe situations described in the previous section.

List of sources

Kamchatnov P.R., Gordeeva.T.N., Kabanov A.A. Clinical and pathogenetic features of the syndrome of vertebrobasilar insufficiency. J. Stroke, 2001; one; 55-57.
Diseases of the nervous system. Guide for doctors. T.1 / Yakhno N.N., Shtulman D.R., Melnichuk P.V. and others. Ed. Yakhno N.N. - M. Medicine 1995.
Losev R.Z., Nikolenko V.N., Sholomov I.I. et al. Diagnosis and treatment of patients with circulatory failure in the vertebrobasilar basin // Saratov Journal of Medical Scientific Research. - 2009. - Volume 5. - No. 4. - S. 629-634.
Samsonova I.V., Solodkov A.P., Burak G.G., Novikova O.V. Vertebrobasilar insufficiency: problems and prospects for solution // Bulletin of the Vitebsk State Medical University. - 2006. - Volume 5. - No. 4. - S. 1-15.
Yakovlev N.A. Vertebrobasilar insufficiency (vertebrobasilar arterial system syndrome). - M.: Provincial medicine, 2001. - 400 p.

Content

Unsteady gait, frequent dizziness - a signal of circulatory disorders in the arteries that feed the brain. Such signs mean the development of vertebrobasilar syndrome. In the absence of timely treatment, the pathology of the arterial system disrupts the functions of the brain. This can lead to stroke and death.

What is vertebrobasilar arterial system syndrome

Several arteries pass through the spine, supplying the brain. The main - basilar - and a network of vertebral (vertebral) vessels. When arterial blood flow is disturbed under the influence of various reasons, this leads to the appearance of such problems:

there is a restriction of the supply of oxygen and glucose to the brain;
his cells lack nutrition;
there is a metabolic disorder;
hypoxia causes ischemic processes;
disorders of the central nervous system (CNS).

Syndrome of the vertebrobasilar arterial system according to international classification diseases ICD-10 has the code G 45.0. This condition is characterized by atrophic lesions of the brain. Violation of blood supply causes damage to the cerebellum, stem part, occipital lobes. To cope with the disease, you need to identify the reason why the basilar artery syndrome developed and eliminate it. Pathology may have other names:

vertebrobasilar syndrome;
vertebrobasilar insufficiency (VBI);
vestibular insufficiency.

The reasons

The appearance of the syndrome of the vertebro-basilar arterial system is promoted by damage to the spine, dysfunction of the vessels. Provoking factors in the development of pathology can be diseases. Among the reasons that often lead to the occurrence of vertebrobasilar syndrome, there are:

genetic predisposition;
spinal injuries in the cervical region;
congenital hypoplasia (underdevelopment) of the vertebral arteries;
fibromuscular dysplasia (Kimmerli's anomaly);
arteritis (inflammation of the arterial walls);
osteochondrosis.

The appearance of vertebrobasilar pathology is promoted by disorders of the functions of the arterial system. These may include the following reasons:

atherosclerosis, causing deterioration of vascular patency;
spondylolisthesis (displacement of the vertebrae forward or backward);
stratification of vertebrobasilar vessels;
thrombosis of the vertebral, basilar artery;
diabetes mellitus, accompanied by damage to small cerebral vessels;
spondylosis (deformation of the vertebrae due to the growth of bone tissue);
squeezing of vessels by a hernia of the cervical spine.

The provoking factors of vestibular insufficiency of the arterial system can be:

antiphospholipid syndrome, contributing to thrombosis;
arterial hypertension;
active head turns;
congenital pathological changes in blood vessels;
birth trauma;
squeezing of blood vessels with prolonged tilting of the head;
blood pathology;
long stay of the head in a fixed position;
diseases of the cardiovascular system.

Symptoms

In case of insufficiency of the vertebrobasilar arterial system, two forms of signs of pathology are often observed. They depend on the nature of the circulatory disorders of the brain. Doctors distinguish the following types of symptoms of the disease:

Temporary - last several hours, occur during transient ischemic attacks. They cause short-term circulatory disturbances that last up to a day.
Permanent - characterized by an increase, deterioration, often lead to acute form which can result in a stroke.

Vertebrobasilar syndrome is sometimes accompanied by such signs that last for a long time:

dull, throbbing pain in the occipital region;
change in coordination of movements;
dizziness;
fainting;
the appearance of noise in the ears;
memory impairment;
distraction;
imbalance;
loss of visual fields;
the appearance of "flies" before the eyes;
weakness;
prostration;
sore throat;
hoarseness of voice;
tachycardia;
nausea;
irritability;
weakness;
change of mood;
sensation of heat.

Chronic vertebrobasilar insufficiency

If left untreated, the symptoms of pathology of the arterial system become permanent. They can intensify, leading to an acute form of vertebrobasilar syndrome. With the development of the chronic stage, the patient sometimes complains of the appearance of such signs of the disease:

concentration disorders;
pathologies of vision - veils before the eyes, flickering;
rapid fatigue;
rapid heartbeat;
hearing impairment;
increased sweating;
speech disorders;
the appearance of swallowing problems;
feeling of a lump in the throat;
pain in the ears;
vomiting.

Acute

Vertebrobasilar insufficiency can come on suddenly. Often it is caused by a hypertensive crisis. The acute form of the pathology lasts from several hours to a day. Vertebrobasilar syndrome in this situation is accompanied by such signs:

dizziness;
hallucinations;
temporary loss of vision;
discomfort in the cervical spine;
headaches;
movement disorders;
loss of consciousness;
restriction of body movement.

Vertebrobasilar crisis can lead to ischemic stroke. In the acute form of the syndrome, the appearance of such signs of pathology is not excluded:

diplopia (double vision);
numbness of the mouth area;
speech disorders;
weakness in the legs;
sudden fall;
pressing pains in the back of the head;
disorientation in space and time;
involuntary trembling of the trunk, limbs;
decrease in performance.

Vertebrobasilar insufficiency in children

The syndrome can develop in patients regardless of age. Violation of the functions of the arterial system that feeds the brain is observed in children from the age of three. Often the cause of vertebrobasilar syndrome is a congenital anomaly in the development of blood vessels. Risk factors include:

spinal injuries caused by sports activities;
damage as a result of falls, transport accidents;
long sitting in an uncomfortable position;
birth injuries of the spine;
perinatal encephalopathy.

If a child has a damaged basilar artery or vertebral vessels that feed the brain, the following signs of vertebrobasilar syndrome are often observed:

violation of posture;
increased drowsiness;
chronic fatigue;
dizziness;
frequent bouts of crying;
intolerance to stuffiness;
fatigue when solving mental problems;
poor tolerance of emotional stress;
neck pain;
sleep disturbance;
excitability;
nosebleeds;
weather dependence;
fainting;
vomit.

Complications and consequences

If signs of vertebrobasilar insufficiency appear, it is necessary to contact specialists for diagnosis and treatment. With circulatory disorders in the arterial system that feeds the brain, the occurrence of serious consequences is not excluded. The patient may develop the following complications:

constant feeling of discomfort in the neck;
circulatory disorders in all organs;
decrease in performance.

The inattentive attitude of the patient to his health, the lack of treatment in the event of signs of vertebrobasilar syndrome, can result in serious consequences:

the occurrence of dyscirculatory encephalopathy (progressive brain damage);
the emergence of the risk of diseases of the cardiovascular system;
the development of cerebral ischemia, stroke;
onset of death.

Diagnostics

Vertebrobasilar insufficiency has symptoms similar to other ailments, which complicates the diagnosis. Doctors are faced with the task of differentiating the disease. same with syndrome clinical picture can be observed in such pathologies:

multiple sclerosis;
vestibular neuronitis (pathology of the vestibular apparatus);
acute labyrinthitis (damage to the nerve receptors of the inner ear);
Meniere's disease (an increase in the volume of labyrinthine fluid in the inner ear);
neuroma ( benign tumor) auditory nerve;
mental disorders.

To prescribe treatment, it is necessary to establish the cause of vertebrobasilar insufficiency. To do this, use the following diagnostic methods:

biochemical blood test;
Doppler ultrasound of the arteries of the vertebrobasilar system;
X-ray of the spine;
magnetic resonance imaging (MRI) - to study changes in the spine;
electrocardiogram;
angiography - examination of blood vessels with the introduction of a contrast agent;
computed tomography (CT) - to detect a hernia;
rheoencephalography - the study of the blood supply to the brain.

To correctly diagnose, differentiate the disease from other pathologies, the following research methods help:

infrared thermography - assesses the patient's condition by thermal fields;
vascular auscultation - a physical method of listening to the arteries;
functional tests with extension, flexion - reveal spondylolisthesis (displacement of the vertebrae);
duplex scanning of cerebral vessels - studies the course of blood vessels, the state of the walls;
neuropsychological testing - reveals the cognitive (mental) functions of the brain;
hearing research.

Treatment of vertebrobasilar syndrome

When diagnosing vestibular insufficiency at an early stage, doctors perform outpatient treatment. Mandatory is a change in lifestyle. The patient is required to do the following:

adherence to a special diet that limits salt, fried, fatty foods;
regular measurement of blood pressure (BP);
giving up alcohol, smoking;
maintaining physical activity.

Treatment of vertebrobasilar syndrome includes a set of measures, which include the use of drugs. The tactics of therapy are selected individually. Doctors prescribe to patients:

vasodilators;
antiplatelet agents that reduce the risk of blood clots;
nootropic drugs that improve brain function;
means of stabilizing blood pressure;
sleeping pills;
painkillers;
antidepressants;
antiemetic drugs;
drugs that reduce dizziness.

In addition to drug therapy, in basilar artery syndrome, such methods of treatment are used to help restore blood circulation in the vertebrobasilar system:

wearing a neck brace;
physiotherapy - magnetotherapy, laser treatment, ultraphonophoresis;
massage;
manual therapy;
treatment with leeches;
acupuncture.

In the absence of treatment results, if necessary, to improve blood flow in the arterial system, the patient is recommended surgical intervention. The following operational methods are used:

Angioplasty is the introduction of a special stent into the vessel to maintain normal arterial circulation.
Endarterectomy - removal of atherosclerotic plaques.
Microdiscectomy - removal of a herniated disc.

Gymnastics

One of the ways to improve the condition with vertebrobasilar syndrome is physiotherapy exercises. Regular exercise of gymnastics removes muscle spasms, activates blood circulation, strengthens the spine, improves posture. During classes, it is recommended to adhere to the following rules:

perform all movements smoothly;
gymnastics is best done in the morning;
perform the complex daily, without interruption;
breathe through the nose, evenly, calmly;
do each exercise 10 times;
take a shower after class.

The complex is performed in the initial position (I.P.) standing. It includes the following exercises:

Stand up straight, tilt your head forward, touch your chin to your chest. Hold for 5 seconds, return to I.P.
Tilt your head to the side, touch your right shoulder with your ear. Hold for 5-8 seconds, return to I.P., repeat on the other side.
Perform head rotations alternately clockwise and in the opposite direction.
Pull the crown up, fix the position for 10 seconds, relax.
Raise your arms through the sides up, join the palms. Hold for 10 seconds, return to I.P.

Medications

In the treatment of disorders of the vertebrobasilar system, one cannot do without the use of medications. They are used in the form of tablets, drops for oral administration, as injections. Doctors prescribe the following groups of drugs:

nootropic drugs - to improve brain function - Glycine, Semax, Piracetam, Cerebrolysin;
antiplatelet agents that prevent thrombosis - Aspirin, Dipyridamole, Clopidogrel, Aggregal, Ticlopidin;
vasodilators - Nicotinic acid, Cavinton.

Much attention in the treatment of insufficiency of the vertebrobasilar system is paid to the elimination of the causes of the pathology. To exclude a hypertensive crisis, lower blood pressure, the following drugs are prescribed:

diuretics - Theobromine, Indapamide;
sartans - Telmisartan, Valsartan;
beta-blockers - Metoprolol, Nebivolol;
calcium channel antagonists - amlodipine. Verapamil;
ACE inhibitors - Dapril, Lisinopril.

Symptomatic therapy plays an important role in vertebrobasilar crisis. Patients are prescribed the following medications:

antispasmodics - Papaverine hydrochloride, Baclofen, Troxerutin;
with dizziness - Betaserk, Trental;
painkillers - Baralgin, Ketanol;
from nausea - Diakabr, Motilium;
sedatives - Novopassit, Afobazol;
antidepressants - Phenibut, Avifen.

Injections contribute to the expansion of cerebral vessels Nicotinic acid. According to the instructions, the drug has the following characteristics:

Indications - ischemic circulatory disorders of the brain, atherosclerosis.
Dosage - 10 mg in the morning and evening, the course of therapy - 2 weeks.
Side effects - lowering blood pressure, redness of the face, headache, allergies.
Contraindications - exacerbation of ulcers, diabetes, gout, hepatitis, liver cirrhosis, pregnancy.

A finding in the treatment of vestibular insufficiency is the drug Papaverine hydrochloride. The tool is distinguished by such qualities:

Action - vasodilator, diuretic, antispasmodic.
Release form - tablets, solution for injection, rectal suppositories.
Indications - hypertensive crisis, vasospasm.
The oral dosage is 50 mg up to five times a day.
Side effects - drowsiness, nausea, lowering blood pressure, heart rhythm disturbances.
Contraindications - intolerance to papaverine, the age of children under 6 months, glaucoma, liver failure.

To improve microcirculation in the vessels of the brain, metabolic processes in its tissues, the nootropic agent Piracetam is prescribed. Instruction medicinal product stipulates the following points:

Indications - dizziness, cerebrovascular accident.
Dosage - tablet three times a day.
Side effects - excitability, irritability, drowsiness.
contraindications - the age of children under one year, pregnancy, lactation, kidney failure, hypersensitivity to the drug.

Treatment with folk remedies

For pathologies of the vertebro-basilar system, you can use the recipes of traditional healers only with the agreement of the doctor. Such funds should be an addition to medical treatment tactics. To prevent the formation of blood clots, it is useful to consume foods containing vitamin C, which helps thin the blood. These include:

sea buckthorn;
viburnum;
cranberry;
currant;
citrus;
kiwi;
bell pepper;
sauerkraut.

Peel three cloves of garlic.
Pass them through a meat grinder.
Put in a jar, leave in a dark cool place.
After three days, squeeze the mixture through several layers of gauze.
Add equal parts honey and lemon juice.

To reduce pressure at arterial hypertension it is useful to drink 100 ml of a product containing natural ingredients three times a day. The course of treatment is repeated 3 times, includes a weekly intake and the same break. The prescription requires:

Put 40 g of corn stigmas in a container.
Add 20 grams of lemon balm.
Pour in the juice of one lemon.
Top up with a liter of boiling water.
Infuse for an hour.

To dilate blood vessels, it is useful to drink an infusion of hawthorn - 20 g of fruit per glass of boiling water. The composition should be kept for 15 minutes in a water bath, insisted for half an hour, consumed in a spoon three times a day, before meals. Infusion promotes vasodilation medicinal herbs. A spoonful of the mixture is required to pour two cups of boiling water, wrap for 30 minutes. One half should be drunk in the morning, and the other half in the evening, taken half an hour before meals. The medical fee includes equal parts of the following components:

birch buds;
immortelle;
yarrow;
hypericum;
chamomile flowers.

To reduce blood clotting in vertebrobasilar syndrome, tincture is used horse chestnut. Take it in a teaspoon in the morning and evening, half an hour before meals. To prepare the medicine you will need:

Take 500 g of horse chestnut seeds.
Grind to a powder state.
Pour in a liter of boiled water.
Leave for a week in a dark place.
Strain.

Forecast

If the patient is correctly diagnosed and timely treatment, it is possible to achieve an improvement in the condition, elimination of signs of vertebrobasilar syndrome. It is important that the patient fulfills all doctor's prescriptions. With late diagnosis, lack of treatment, the development of a chronic form of pathology is not excluded. This can lead to the following consequences:

deterioration of well-being;
frequent ischemic attacks;
development of discirculatory encephalopathy;
the occurrence of a stroke;
in severe cases - the onset of death.

Prevention

To prevent the occurrence of vertebrobasilar syndrome, you must follow some rules. It is important to seek medical help when symptoms of the disease appear. Prevention of damage to the arterial vessels that feed the brain includes the following activities:

adherence to a diet - the exclusion of fatty, smoked, fried foods that contribute to the formation of blood clots;
performing therapeutic exercises;
to give up smoking;
exclusion of alcohol consumption;
reducing salt intake.

To slow down the development of the syndrome, it is important to practice moderate physical activity. Prevention of vertebrobasilar insufficiency involves the following measures:

constant monitoring of blood pressure;
stabilization of its performance with drugs;
regular walks in nature;
avoidance of stressful situations;
exclusion of injury during sports;
creation of comfortable conditions for sleep;
observation by a doctor, periodic examinations;
the exclusion of uncomfortable postures that cause a disorder in the blood supply to the brain.

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In the article, we will consider what it is - the diagnosis of VBI and the consequences of this pathology.

The human brain is supplied with blood according to a certain pattern. Vertebrates are separated from those located in the upper part of the sternum, which then enter the holes located in the transverse processes of the cervical region and enter the skull. At the base of the cranium, they are included in the basilar artery, which passes in the brain stem, cerebellar and occipital regions of the cerebral hemispheres. In the future, the basilar artery is divided into vessels that are responsible for supplying blood to a certain hemisphere of the brain.

If the fullness of blood in the arteries supplying the brain decreases, including due to osteochondrosis of the cervical region, the so-called vertebrobasilar insufficiency or VBI develops. Since the blood supply to the brain becomes insufficient, against the background of the diagnosis of VBN, a deficiency of nutrients and oxygen occurs, which disrupts the proper functioning of the organ, there are characteristics diseases.

The reasons

There are many reasons for the development of the diagnosis of VBI. Young and middle-aged patients suffer from the disease due to external compression of the vertebral arteries due to their compression by growths of bone tissue or osteophytes, as well as against the background of disc herniation and spasms of the neck muscles.

In addition, it may occur due to the deformation process in the canal of the spinal artery against the background of subluxation of the cervical vertebrae. In some cases, the development of VBN is due to such pathological abnormalities as hypoplasia of the vertebral arteries, Kimmerli's syndrome, and the presence of an additional cervical rib.

Pain spasm

Painful spasm of the vertebral arteries also plays a significant role in the development of the diagnosis of VBN. In the region of the spinal arteries there are small branches that originate from autonomic nerves that form the nerve plexus. If the patient has a history of osteochondrosis, pain in the neck can provoke a pathological process in the form of VBN. In addition, due to the pain syndrome, irritation of the vertebral structures and hyperactivation of the sympathetic nerves occur. As a result, innervation of the vertebral arteries occurs, accompanied by a prolonged and sustained spasm.

Diagnosis of VBN in a child and the elderly

In childhood, the onset of the disease may be due to the anatomical features of the structure of the spine, associated with a family history, or obtained as a result of birth trauma and TBI in infancy.

In very many children in neurology, the diagnosis of VBN is detected.

In old age, vertebrobasilar insufficiency may be the result of atherosclerotic changes in the arteries of the spine. In this case, atherosclerotic plaques form in the lumen of large vessels. Plaque contains a large amount of cholesterol, which clogs the lumen of the artery and disrupts the blood supply to the brain.

In some cases, blood clots occur in the areas of plaque localization, which further block the arterial lumen. The blood supply may also be interrupted as a result of blockage of the artery by a clot formed in another area of the body and passed through the bloodstream into the pool of vertebral vessels. In this case, we are talking about thromboembolism.

The diagnosis of VBN in neurology is established quite often.

The syndrome may be caused by incorrect conduction medical manipulations, as well as manual therapy and trauma to the spinal region. Another risk factor for the development of the syndrome is stenosis of the subclavian artery, which provides blood supply to the upper extremities.

Against the background of fibromuscular dysplasia, numerous medium-sized arterial stenoses are formed. In some cases, the arteries of the spine are also involved in the pathological process, which leads to the diagnosis of VBI.

Symptoms

Manifestations of vertebrobasilar insufficiency can be quite diverse. Neurological signs of pathology may include visual, vestibular and conduction or sensory disturbances. In addition, with the diagnosis of VBN in neurology, a dysfunctional disorder of the nerves located in the skull is observed.

On the part of the musculoskeletal system, VBN is manifested by impaired coordination, as well as central paresis. As a rule, the syndrome is characterized by a combination of dynamic ataxia and intentional tremor in the extremities, as well as reduced muscle tone of an asymmetric type.

Expression and combination various symptoms VBN is due to the extensiveness of ischemic lesions and their localization, as well as the possibility of collateral circulation.

Sensory disorders are often accompanied by hypo- or anesthesia in one half of the trunk or limb, as well as multiple paresthesias.

In every fourth patient diagnosed with VBI, the symptoms may vary, but almost always there are violations of superficial and deep sensitivity, which is explained by a disorder in the work of the ventrolateral thalamus in the areas of blood supply to the external villous artery in its posterior part. It is far from always possible to detect circulatory disorders in the region of the arteries of the spine; therefore, it is often necessary to additionally use neuroimaging methods.

Visual disturbances in VBI are accompanied by symptoms such as scotoma, cortical blindness, homonymous hemianopsia, and photopsia.

If the brain stem is also affected, there are disturbances in the functioning of the nerves of the skull. The result is paresis. facial nerve, bulbar syndrome, various eye movement disorders.

The listed symptoms, as a rule, appear in combination, however, in exceptional cases, there are single signs, which is explained by the reversible type of ischemia in the system of vertebrobasilar vessels.

Quite often, pathologies of the vertebral arteries associated with a compression crisis in the cerebrovascular system are also associated with sciatica in the neck. Signs of this disease are painful palpation and limited cervical mobility. The severity of the pain syndrome increases with turning and tilting the head.

Dizziness and disorder of the autonomic system

Paroxysmal dizziness can also indicate problems with the blood supply to the brain. This phenomenon is due to the high sensitivity of the vestibular apparatus to ischemic symptoms. Dizziness can be mixed or systematic, while the movement is rectilinear, and the patient feels it, both the rotation of the objects around him and his own body.

Another one stands out characteristic symptom VBN - disorders vegetative system accompanied by nausea and vomiting, a violation of the heart rate, increased blood pressure and severe hyperhidrosis.

In combination with other symptoms, impaired auditory perception can also indicate VBI. This can be both a decrease in the quality of hearing, and congestion, tinnitus. As a rule, such a sign indicates ischemia in the region of the lower anterior part of the cerebellum.

It must be understood that the listed symptoms are also characteristic of other pathologies of the brain and cardiovascular system, so it is important to full examination and differential diagnosis to clarify the diagnosis.

Diagnostics

The most important step in diagnosing vertebrobasilar insufficiency is to identify the cause that provoked the development of the pathological process. For this purpose, a detailed neurological examination is carried out, aimed at differentiating the disease from similar pathologies. So, to identify VBI, the following instrumental studies are carried out:

1. Doppler ultrasound allows you to assess the state of blood supply to the vessels of the brain and This method combines duplex scanning and dopplerography, gives an idea of the state of the vertebral arteries.

2. Rheoencephalography in conjunction with infrared thermography also allows you to evaluate the state of the arteries of the brain and spine, but they are less informative than the previous method.

3. Computed and magnetic resonance imaging make it possible to detect the presence intervertebral hernias, as well as other pathological processes in the spinal column, which can lead to the development of VBI.

4. X-ray examination assesses the condition of the vertebral cervical region.

5. Functional trials, carried out with extension and flexion, allow you to determine the presence of spondylolisthesis.

In some cases, no less effective methods diagnostics can be such as acoustic stimulation, vestibulological examination, audiometry, etc. Laboratory methods diagnosis of VBN is a blood test for biochemistry and coagulation.

What is the treatment of VBI against the background of cervical osteochondrosis?

Medical treatment

The choice of a therapeutic regimen directly depends on the degree and nature of vascular damage. Conservative treatment vertebrobasilar insufficiency includes the following drugs:

1. Antiplatelet agents. The action of this group of drugs is aimed at reducing blood clotting. The use of antiplatelet agents is due to the need to prevent the formation of blood clots. Aspirin is the most common blood thinner. It should be borne in mind that acetylsalicylic acid negatively affects the state of the gastrointestinal tract and can cause hemorrhagic syndrome. It is contraindicated to take it with existing pathologies of the gastrointestinal tract, and it is also not recommended to drink tablets on an empty stomach.

2. Drugs that dilate blood vessels. They are necessary to prevent obstruction of blood vessels. As a rule, course treatment is required in spring and autumn. The dosage should be increased from the lowest to the optimum therapeutic amount. If monotherapy does not give positive dynamics in the patient's condition, it is recommended that several similar drugs be taken simultaneously.

3. Metabolic and nootropic drugs. The most commonly prescribed are Piracetam, Actovegin, Glycine, Nicergoline, Semax, etc. These drugs are used to stimulate the work of the brain, reduced against the background of VBN in cervical osteochondrosis.

Treatment is not limited to this.

In addition to these drugs, vertebrobasilar insufficiency can be treated with drugs that normalize blood pressure. On an individual basis, painkillers, antidepressants, hypnotics and sedatives, as well as antiemetics and drugs that stop dizziness can be prescribed as additional drugs. These drugs contribute to the elimination of symptoms in the diagnosis of VBN in neurology.

Treatment should be comprehensive and timely.

Other treatments

If the course of vertebrobasilar insufficiency is characterized as severe, surgical intervention may be prescribed. The purpose of the operation is to eliminate circulatory disorders caused by VBN. This is done by expanding the basilar and vertebral arteries. In addition, the operation allows you to eliminate compression intervertebral discs, relieve tension and stenosis from them. As surgical treatment manipulations such as endarterectomy and microdiscectomy can be performed.

Neurologists believe that the treatment of vertebrobasilar insufficiency should take place in combination. For this reason, patients with this diagnosis, in addition to drug treatment, are assigned to perform special therapeutic exercises as well as physiotherapy procedures.

In addition, the treatment of VBI is carried out using the following methods:

1. Therapeutic massage aimed at improving blood circulation.

2. Visiting a chiropractor.

3. Acupuncture and reflexology, eliminating muscle spasms.

4. Hirudotherapy. Almost all vascular diseases can be eliminated by leeches as additional method treatment.

5. Magnetotherapy. Favorably affects the circulatory system.

6. Wearing a special corrective corset around the neck.

Timely and correct treatment of VBN against the background of cervical osteochondrosis allows you to completely eliminate the disease. Otherwise, the risk of the transition of the pathology to a chronic form increases, as well as a significant deterioration in the quality of life of the patient.

Forecast

The prognosis for vertebrobasilar insufficiency is made on the basis of the severity and nature of the disease of the cardiovascular system that caused this syndrome, as well as the degree of damage to the arteries and the possibility of establishing a bypass blood supply to the brain.

If the arteries show a tendency to narrow more, and the correct therapy has not been carried out in a timely manner, the risk of developing irreversible consequences and complications increases. Such patients are prone to stroke, as well as dyscirculatory type encephalopathy against the background of a stable neurological deficit.

A favorable prognosis for VBI is possible only in the case of a satisfactory assessment of the state of the cerebral vessels, as well as with properly selected treatment against the background of a mild pathology.

Prevention

Mandatory preventive measures for VBI are:

1. Stop smoking, drinking alcohol and drugs.

2. Regular monitoring of blood pressure indicators.

3. Compliance with a special diet. Sweet pastries, salt, spicy and spicy foods, marinades and canned food are subject to restriction. Recommended foods for VBI are seafood, fruits and vegetables, low-fat dairy products.

4. Presence of moderate physical activity medium intensity.

In some cases, these measures are enough to stop the disease, even in the absence of medical and physiotherapeutic support.

If the disease was detected at the initial stage of its development, treatment is carried out on an outpatient basis. With a later detection of the pathological process, hospitalization is recommended. This is done to prevent the development of a stroke.

We looked at the symptoms and treatment of VBI.