Basilar artery thrombosis

In modern conditions, pathologies and diseases associated with the disruption of the normal functioning of the heart, blood vessels are increasingly observed. Various pathologies of the vascular bed are assigned the third place in the system of the general morbidity of man. In connection with malnutrition, constant stresses, negative environmental factors, the risk of blood clots is now sharply increasing.

Thrombosis is the formation of a clot (blood clot) in the lumen of a blood vessel. The most dangerous are arterial thromboses. The most dangerous of all known thromboses is thrombosis of the basilar artery.

Under the basilar artery is meant the artery, which is formed in the lower part of the medulla oblongata. It ensures the full operation of the entire brain. The basilar artery is formed at the point of fusion of paired carotid arteries and paired vertebral arteries. It is she who is responsible for the supply of sufficient amounts of oxygen and nutrients to the brain. By means of the basilar artery, approximately 70% of all necessary blood is delivered to the brain. Various of its lesions, including thrombosis of the basilar artery can result in death. As a result of the development of thrombosis of the basilar artery, a stroke, often having a lethal outcome, may develop.

[1],

Epidemiology

Thrombosis of the basilar artery is defined as a syndrome. This syndrome most often is a concomitant disease in osteochondrosis: every third person has a thrombosis.

It occurs in both adults and children. Elderly people suffer from this syndrome 3 times more often than adults, and 4.5 times more often than teenagers and children. In the elderly and senile age, approximately 60% of cases end in disability, 10% with death. While in childhood these figures are 15% and 1.5%, respectively. Often thrombosis of the basilar artery occurs in combination with such diseases as:

• Embolism in the vertebrobilar region - 21%;
• arrhythmias in combination with thromboses in other parts of the body - 25%;
• atherosclerosis - 21%;
• presence of thrombi in the lower extremities - 16%;
• clamping of arteries - 6%;
• a strong blood clotting, a violation of the function of platelets - 7%
• other pathologies - 4%.

[2], [3], [4], [5], [6], [7]

Causes of the basilar artery thrombosis

The main cause of thrombosis of the basilar artery is the formation of a thrombus in the wall of the basilar artery. The reasons for the development of thrombosis of the basilar artery may be as follows:

• Congenital pathologies, such as an abnormal structure of the walls of blood vessels, a violation of the vascular tone. Also the process of thrombosis is promoted by such pathologies as Kimmerpi anomaly, various hypoplasia, dystonic changes;
• Congenital anatomical features of arteries (abnormal tortuosity of vertebral and major arteries, insufficient number of anastomoses at the base of the brain);
• Injuries of various types (sports, household, road transport). In the first place, the danger is represented by traumatic effects, traumatic injuries in the cervical collar zone, occiput;
• Inflammatory processes in the walls of blood vessels;
• Arterial stenosis, which results in a thrombus;
• Atherosclerotic lesions of blood vessels;
• Microangiopathy, which is the result of various diseases;
• Antiphospholipid syndrome, accompanied by a violation of the lumen of blood vessels;
• Violation of the biochemical cycle and hormonal background;
• Compressive disorders that result from hypertrophy of staircase and cervical vertebral hyperplasia;
• Compression of the basilar artery or vertebral artery by hernia, spondylosis and other concomitant pathologies;
• Antiphospholipid syndrome, accompanied by violation of the patency of blood vessels;
• Violation of the biochemical cycle and hormonal background.

[8], [9], [10], [11]

Risk factors

The likelihood of developing a basilar artery thrombosis increases with the following risk factors:

• Malnutrition, leading to the deposition of cholesterol plaques. Excessive consumption of food containing fat, oil, cholesterol. Fast food (fast food), lack of diet;
• Genetic predisposition to thrombosis;
• Violations of the basic properties of blood;
• Disorders of blood microcirculation;
• Cardiogenic embolism, small arterial embolism
• Complete occlusion of the lumen of the blood vessel, resulting from atherosclerotic stenosis.
• Long stay in uncomfortable position.

Pathogenesis

At the heart of the pathogenesis of the basilar artery thrombosis lies a reversible disruption of the function of the basilar artery, its conductivity, which arises as a result of thrombogenesis in the arterial stratum.

As a consequence, there is a violation of the functional state of the brain, which is associated with a violation of blood circulation in the area that feeds the main and vertebral arteries. Neurological symptoms develop. There is an acute ischemia of the brain.

The severity of the disease and the severity of the symptoms depends on the location of the pathological process and its size, as well as on the possibility of collateral circulation.

[12], [13], [14], [15]

Symptoms of the basilar artery thrombosis

The diagnosis of thrombosis of the basilar artery is based on a symptom complex, which includes such violations as:

• visual disorders (loss of visual field, agnosia, blindness, photopsy, blurred vision, the appearance of visual images);
• impairment of motor functions of the eye;
• violations of the vestibular apparatus;
• pathology of the pharyngeal and guttural function (a person can feel discomfort in the throat, may be concerned about the feeling of "coma" in the throat, perspiration, cramps and difficulty in swallowing, hoarseness, coughing);
• vegetative disorders: nausea, vomiting;
• disorders of sensory (sensitivity), skin damage;
• motor disorders (paresis, ataxia, impaired sensitivity). There are also violations of gait, which can be accompanied by tremor, muscle tone decrease;
• asthenic syndrome;
• psychiatric disorders.

All symptoms are conventionally divided into two categories: paroxysmal and permanent. Paroxysmal symptoms and syndromes are observed sporadically, during attacks and exacerbations, manifested in acute form. The permanent symptoms are of a sluggish character, proceed for a long time, acquire a chronic form.

[16], [17],

First signs

In the event that a person has a sharp decrease in hearing acuity, which is combined with noise in the ears, one should be alert. This may be the first indication that the process of thrombosis in the basilar artery has begun.

The appearance of audiological disorders, the increase in the intensity of noise in the ear may indicate cerebrovascular insufficiency.

At the initial stages of thrombosis of the basilar artery, there may be a short-term loss of hearing, which is combined with noise in the ears. Such patients need close attention, since in the future the situation may worsen.

Since the basilar artery supplies blood to the body of the body - the brain, the pain can not be ignored. Especially if these symptoms are permanent and prolonged, they become chronic and systematic. They can also be the first signs of thrombosis of the basilar artery.

[18], [19],

Stages

Thrombosis of the basilar stage develops in several stages. The first stage is the initial stage. At this stage there are precursors or thrombosis first manifests itself against the background of general weakness, pain symptoms in the nape of the neck. At this stage it is important to diagnose thrombosis in a timely and correct manner, to prescribe the right therapy, then a favorable prognosis is possible. Perhaps outpatient treatment.

The second stage is the formation of a blood clot. At this stage a thrombus forms in the lumen of the basilar artery, the lumen of the artery contracts, the blood supply of the brain is disturbed. The condition worsens. Hospitalization, inpatient treatment is necessary. Need constant monitoring by the doctor to prevent stroke, comprehensive treatment.

The third stage is the stage in which the clot is sufficiently pronounced and breaks the normal functioning of the brain. With incorrect and untimely treatment, complications in the form of a stroke, serious consequences, including disability and death, are possible. At this stage, the neurosurgeon needs help, which consists in ectomy of the thrombus and restoration of the blood circulation of the brain.

The outcome of therapy depends on the timeliness of diagnosis, proper treatment, properly selected rehabilitation measures.

[20], [21]

Forms

Thrombosis of the basilar artery is a diagnosis. In ICD-10, it is characterized as a syndrome, not a disease and is one of the subspecies of general thrombosis.

Thrombosis of the basilar artery can be manifested by the following syndromes:

• Wallenberg-Zakharchenko syndrome (occurs as a result of lesion of the posterior lower part of the brain);
• Dejerine and Miyar-Goebler syndrome (medial branches of asthma are affected by thrombosis);
• Jackson syndrome - occurs as a result of the lesion of the anterior zone of the basilar artery;
• syndromes of Benedict, Weber, in which the posterior cerebral arteries and intercostal branches of the basilar artery are affected.

[22]

Complications and consequences

Thrombosis of the basilar artery is dangerous because it can have serious consequences and complications that often have a lethal outcome.

Since the disease is associated with the formation of a thrombus in the basilar artery, its main danger is that it can come off and clog the vessel completely.

In this case, a stroke occurs. A frequent complication is ischemic stroke of the brain, which occurs in the area of the vertebrobasilar basin. This pathology entails disability.

The consequences of a stroke can be a systematic violation of blood circulation, dizziness, full or partial restriction of the ability to move the eyes, there is a weakening of the eye muscle, nystagmus of the eyeballs. A frequent violation is strabismus. Often a person is not able to walk smoothly, control his movements in space. The patient moves, like a drunk, while there may be tremors, paralysis of the whole body or individual segments of the body, loss of sensitivity.

The consequences of a stroke can also be mental retardation, isolation, lack of socialization, difficulties in communication and learning, constant headaches, migraines. In some cases, there may be a lethal outcome.

[23], [24]

Diagnostics of the basilar artery thrombosis

It is quite difficult to diagnose thrombosis of the basilar artery. First, this disease can have many objective and subjective symptoms. Secondly, this diagnosis must be diagnosed in a timely manner. Thirdly, the disease must be differentiated from a number of other diseases that have a similar symptomatology. Therefore, it is strictly forbidden to diagnose independently and engage in self-medication. As soon as you began to worry about early symptoms that could indicate thrombosis of the basilar artery, you should consult a neurologist.

Instrumental diagnostics

When diagnosing a disease, it is important to know the cause of the disease. For this, instrumental methods are used, and laboratory investigations are carried out.

For diagnosis, the following methods are used:

• ultrasound dopplerography. This method makes it possible to determine the occlusions, the speed of blood flow, the peculiarities of the movement of blood flow along the arteries of the vertebrobasilar basin;
• Angiography, with which you can study the features of arterial walls;
• X-ray of the spine, which allows you to assess the overall condition of blood flow, arteries;
• with the use of a computer tomograph (CT) and a magnetic resonance imager (MRI), there were opportunities to evaluate the blood flow, identify various pathologies;
• infrared thermography, with the help of which the state of individual organs and systems is evaluated on the basis of analysis of thermal radiation;
• Rheoencephalography, which allows you to evaluate the features of supplying the brain with blood;
• MR-angiography, with the help of which the channel is studied vascular bed.

[25], [26], [27]

Analyzes for thrombosis of the basilar artery

The main type of laboratory study is a blood test for biochemistry, which allows you to track changes in the biochemical cycle, identify inflammatory processes. Significant may be a study of the coagulating properties of blood and the study of its biochemical composition. It is important to assess such indicators as glucose, lipid levels.

Also important information can be obtained in the study of blood coagulability.

[28], [29], [30]

Differential diagnosis

Thrombosis of the basilar artery must be differentiated from a number of other pathologies that have similar features. First of all, it is necessary to differentiate from the usual benign paroxysmal dizziness, which can be caused not by a thrombus, but by a common lesion of the vestibular apparatus of various etiologies. As a rule, these lesions are not associated with circulatory disorders. A reliable test that distinguishes thrombosis from lesions of the vestibular apparatus is the Hallpike test.

It is also necessary to refute the patient's presence of vestibular neuronitis, acute labyrinthitis, Ménière's disease, hydrosublibrinitis, which in most cases are a complication of chronic otitis media.

After that, differentiate from perilymphatic fistula, which arises as a consequence of the transferred trauma, operation. Often thrombosis of the basilar artery can be confused with the neurinoma of the auditory nerve, demyelinating diseases and normative hydrocephalus, which is a complex of cognitive disorders.

In some cases, it is necessary to differentiate from emotional and mental disorders, which manifest themselves as anxious, depressive states. There may also be some similarities with thrombosis in various pathologies of degenerative and traumatic nature, auditory disorders, tinnitus.

When diagnosing, the doctor must take into account that similar violations occur in elderly people. Approximately one third of the elderly population notes systematic tinnitus. And most patients claim that they experience high-intensity noise. These feelings, as a rule, cause great inconvenience.

As a result of cerebrovascular pathology, various auditory disorders can develop. These processes occur in most cases in the middle ear. There may be short-term episodes of hearing loss that can be combined with noise in the ears.

Treatment of the basilar artery thrombosis

Treatment of thrombosis can be outpatient and inpatient. Outpatient human can be treated at the initial stages of the manifestation of thrombosis, in cases where early symptoms manifest themselves, or their manifestation has not even begun. In acute or neglected phase, people are necessarily hospitalized, as it requires constant monitoring and control by medical personnel. The main goal of hospitalization is to prevent strokes. This form of treatment is called stationary.

Usually complex therapy is used - medicines, physiotherapy. Alternative means are acceptable, but it is better to consult a doctor beforehand. Remember that thrombosis is a rather dangerous diagnosis. Even the slightest mistake or inaccuracy can cost you a lot.

Basically, treatment is determined by the cause of the disease, and is selected individually for each patient. Timely and correct determination of the cause of the disease is the main factor of successful treatment.

Drug treatment, as a rule, includes the use of vasodilator drugs (vasodilators). These drugs prevent occlusion. Often used in spring and autumn. Doses are small at first, then gradually increase.

Also prescribed antiplatelet agents are drugs that convert blood into a more liquid fraction, due to its coagulability is significantly reduced, which in turn inhibits the formation of thrombi. Complex therapy includes metabolic and nootropic drugs that improve the functional processes in the brain. If necessary, antihypertensives can be prescribed.

It is recommended to use drugs that have a systematic effect. Anesthetics are used (if there is a need for them), hypnotics, antidepressants. If necessary, prescribe drugs against dizziness, antiemetics.

Drugs used for thrombosis of the basilar artery

First of all, drugs are needed that will make the brain function fully, making the most of its functional and energy reserves. They will eliminate symptoms, remove pain syndrome. Preparations are relatively safe, require long-term use. The main precaution is to observe the dosage, the regimen of taking the drug. It is recommended to consult a doctor, especially if the combination is taken with other drugs and procedures. Side effects and cases of overdose are rare. In some cases, the patient may be dizzy, can vomit, make noise in the ears. Sometimes there is a clouding of consciousness.

It is recommended to use the drug nicergoline. The dose depends on the characteristics of the patient. On average, 5-10 mg should be used. The number of receptions is three per day.

Effective drug such as cinnarizine. Begin intake should be from the minimum concentrations - 12.5 mg in the morning, at lunch and evening. Gradually, the dosage is increased to 25-50 mg at a time. The drug should be taken after a meal.

Another drug that can be recommended for thrombosis of the basilar artery is pyrocetam. Apply it is recommended for 0.8 g. Take the drug as soon as you wake up, during the day and before going to bed. Duration of admission is 2 months.

You can also recommend cerebrolysin. This drug is used for 5-10 ml intravenously. The course of therapy ranges from 5-10 injections.

[31], [32]

Vitamins recommended for thrombosis

The main vitamin, which is recommended for use in thrombosis of the basilar artery, is vitamin C, which has antioxidant properties. It strengthens and cleanses the walls of blood vessels, dilutes blood, prevents the accumulation of platelets. It is necessary to consume 500-1000 mg daily. The course of treatment is 2-4 times a year, for 30-35 days.

Vitamin D. It is recommended to use in a dosage of 35-45 mcg per day. This vitamin improves blood flow, increases platelet lysis.

It is recommended to use B vitamins in a dosage of 3-4 mcg per day, the course is approximately 1 month. These vitamins strengthen the wall of blood vessels, increase blood flow, reduce the risk of blood clots.

Surgical treatment of basilar artery thrombosis

In the event that drug therapy and physiotherapy are ineffective, a surgical method is used. It is aimed at the mechanical elimination of thrombus and the limitation of the affected area from the total blood flow (endarterectomy). Also, the surgical method can be aimed at improving blood flow. A common type of surgical intervention is angioplasty, during which a special stent is inserted into the basilar artery, preventing the narrowing of the arteries lumen. This helps normalize blood circulation.

Direct and endovascular methods are used. The method is chosen after a preliminary examination, and is determined by the size and features of the pathology, localization and severity of the pathological process, and the state of the blood flow.

Postoperative treatment and patient recovery are also performed. After the operation, the main treatment is just beginning. Requires a long course of therapy and rehabilitation. Treatment, as a rule, includes fighting with brain edema, thrombosis. It is also necessary to normalize the water-electrolyte balance and apply various symptomatic remedies aimed at eliminating symptoms.

After elimination of the main symptoms and normalization of the condition, it is necessary to apply therapeutic exercise. Exercises are also chosen individually. It is recommended to take a course of manual therapy, physiotherapy. Well-proven acupuncture.

Physiotherapeutic treatment

Physiotherapy means manual therapy, hirudotherapy, reflexology, magnetotherapy, wearing cervical corset. It is also useful to attend massage sessions and physical therapy classes. One or several methods are prescribed in the complex, depending on the individual course of the disease, state of health.

Alternative treatment

Alternative agents can be very effective in treating thrombosis of the basilar artery. However, only a combination of therapy prescribed by a doctor and alternative drugs can contribute to the successful treatment and overcoming of the disease. If in doubt, it is always better to consult a doctor.

Garlic. At a thrombosis the blood is condensed (for this reason the thrombus is formed). Garlic liquefies the blood and, consequently, thrombi are formed less often. Take 3 large heads of garlic, pass through a meat grinder, or squeeze out with the help of a scabbard. The resulting mass is transferred to a jar and put in a cool place. Let it persist for 3 days, strain. To the resulting extract, add about the same amount of juice from the freshly squeezed lemon, honey. Apply about 15 grams of the slurry (in the evening). It is stored in the refrigerator.

Horse chestnut. This is a tool that helps reduce blood clotting .. Take about 500 g of chestnut seeds. Do not separate the peel. Wipe clean. Pour 1.5 vodka. Insist the drug for a week, then strain. Drink about 5 g of infusion, half an hour before you start eating. Three-time use will suffice.

Hawthorn. Has vasodilating properties. Collect about 20 g of hawthorn fruit, pour a glass of boiling water. Keep in a water bath for about 3 minutes. After insisting the remedy is about half an hour. Drink 15 grams in the morning, at lunch, in the evening.

[33], [34], [35], [36]

Herbal Treatment

It is recommended to use the following herbs: nettle, nettle, walnut, common hops.

Infusion of nettles. The method of preparation is as follows: 1 tablespoon of nettle leaves + 250 ml of boiling water. Let the broth brew for half an hour. Then filter. Drink 60-70 ml in the morning, in the afternoon and in the evening.

Acacia white is used in the form of alcoholic infusions, externally. Method of preparation: 60 g of acacia color is filled with a glass of vodka and it is insisted for 7 days. After that, rub in the inflamed areas of the veins and arteries of the occiput.

Walnut forest is used in the form of infusion. Use bark and leaves. In order to prepare the infusion, 15 g of finely chopped or wiped sheets and bark should be filled with a glass of boiling water. Then heat to boiling. They give an opportunity to brew for an hour. Then it should be filtered. Apply inside half cup, 2 times a day.

Cones of hops are used in the form of decoction. Cones are crushed. 15-30 g cones pour 250 ml of boiling water, heated in a water bath for 15 minutes, filter. Drink 125 mg three times a day.

Homeopathy with thrombosis of the basilar artery

Homeopathic remedies for thrombosis of the basilar artery are used to purify blood vessels, dilute blood, eliminate toxins, prevent thrombosis. The method is useful and relatively safe, because side effects occur rarely.

In case of an overdose, nausea, vomiting, dizziness, drowsiness may occur. Precautions - do not take without prior consultation with a doctor, late stages of thrombosis, after surgery (if the doctor did not include these funds in the complex therapy).

The following tools are recommended:

Mummy. It is recommended to use the mummy inside (balm of the Central Asian mountains). Take inside 0.2 g 2 times a day, before meals. Spend 2-3 courses for 10 days. Breaks between courses - 5-10 days.

Herbal collection "Bouquet of Altai". For preparation, take the following ingredients:

• Badan tolstolisty (black leaves) - 2 parts
• Golden root - 1 part
• Kopecnik forgotten - part 1
• Cowberry leaves - 1 part
• Leaves of blueberry ordinary - 1 part
• Leaves of willow-tea - part 1
• Currant leaves - 1 leaves
• Thymus mountain - 0.5 part.

To prepare 30-45 g of the substance, 1000 ml of boiling water are poured in, allowing 20-30 minutes to infuse. Drink 400-600 ml per day.

You can add honey.

Chinese magnolia juice. Take inside 15 g each for a glass of tea two or three times.

Hawthorn juice is blood-red. Take inside for 30 g for half an hour before meals, in the morning and at bedtime.

Prevention

Thrombosis of the basilar artery can be prevented, therefore, it is necessary to follow the preventive measures of this disease. To prevent thrombosis, you must follow a diet, proper nutrition. You need to eat less fatty, fried foods that contain cholesterol, fatty acids. You can not eat fast food. It is necessary to eat more seafood, garlic, berries, citrus fruits. Also need to include in the diet more vegetables, especially tomatoes, sweet peppers.

You need less salt.

From bad habits it is necessary to refuse. Smoking, alcohol aggravate the disease.

The habit should include constant physical activity. Especially useful therapeutic exercise.

Continuous monitoring of blood pressure is necessary. You can not sit in an uncomfortable position for a long time.

Swimming is also useful. Pool should be visited at least 2 times a week.

Periodically, it is necessary to conduct preventive examinations, preventive courses of treatment.

[37],

Forecast

The outlook is in most cases unfavorable. It can be beneficial only if all the recommendations of the doctor are followed, with correct treatment, comprehensive treatment, with timely diagnosis.

In the absence of proper treatment, do not wait for a favorable prognosis. The patient's condition will constantly deteriorate. There may be ischemic attacks, which will increase with each passing day. Eventually, stroke develops, discircular encephalopathy, which end in irreversible brain damage.

[38], [39], [40]