Vertebrobasilar insufficiency (VBI) means poor circulation of blood in the vertebral and basilar arteries. The vertebral arteries run up on either side of the vertebral column in the neck. They then combine to form the basilar artery. This artery then runs up to the brain.
These arteries or their branches may be blocked completely by a clot, resulting in a stroke. They may be involved in a temporary block. The vertebral arteries may also be kinked and narrowed by certain movements of the neck. This is common in older people with osteoarthritis. These arteries supply blood to the parts of the brain associated with balance, eye function, memory and muscle action. They also supply the vital brain stem that controls breathing and consciousness.
A major block is occasionally fatal. Mostly it produces difficulties in walking, balance problems and double vision: a form of stroke. Minor or short-lived attacks may cause dizziness, nausea or drop attacks. These seem like faints, except that the onset is sudden.
There is often no warning and the patient recovers consciousness in a few seconds. Another symptom is a passing loss of memory, known as transient global amnesia. The patient is unable to remember new information or past events. There is normal consciousness and normal activities such as eating and walking continue. There is some confusion. Recovery from this condition is normally complete.
How does Vertebrobasilar Insufficiency occur ?
Hardening of the arteries leads to irregular narrowing of the artery concerned. Small blood clots can form, further narrowing the artery so that the blood does not flow easily and the brain gets insufficient oxygen. This causes the symptoms. A drop in blood pressure, sometimes because of tablet treatment for heart failure, Parkinson's disease or depression, can bring on an attack. The twisting of the neck, kinking the arteries, is a further way in which the symptoms may be caused.
Why does Vertebrobasilar Insufficiency occur ?
Atheroma (hardening of the arteries) can be due to incorrect diet (too much fat and calories), smoking and high blood pressure. Sometimes, none of these factors seem to be operating.
Treatment Involved for Vertebrobasilar Insufficiency
Blood tests and a heart tracing (ECG) are usually done to exclude diseases which may make the blood too thick. An x-ray of the spine may show bony outgrowths from the vertebrae in the neck. Soluble aspirin may be used to reduce the likelihood of more clots forming on the wall of the artery. If symptoms occur with certain neck movements, these can be discouraged by wearing a soft collar. Sometimes physiotherapy also helps to improve the range of safe movement of the neck. This must be done cautiously.
During Treatment
Most episodes of VBI last only a few minutes. If attacks become more frequent or last longer, the doctor must be contacted. Treatment is usually continuous and requires regular visits to check that the situation is quite stable.
If Vertebrobasilar Insufficiency is left untreated
Injuries may be sustained through falling. Unsatisfactory treatment is more likely to result in the development of a stroke. This often produces permanent disability.
Effects on Family of Vertebrobasilar Insufficiency
VBI is not inherited. Family and friends may help the patient to avoid certain movements known to set off attacks, and also encourage him or her to adopt a healthier lifestyle.