Syndrome of the vertebral artery

Diseases of the nervous system are inextricably linked with diseases of the blood vessels, because often with neurological pathologies symptoms such as dizziness, headaches, fatigue, sensation of "flies" before the eyes, mental disorders are observed. One of these vascular pathologies is vertebral artery syndrome - a painful condition that not only negatively affects the patient's performance, but also worsens the quality of life.

Causes of the syndrome of the vertebral artery

In most cases, vertebral artery syndrome is caused by painful changes in the spine, in the muscular framework surrounding the vertebral column. Also provoking factor is various diseases of arterial vessels themselves.

Thus, we can identify the main possible causes of the syndrome:

• congenital vascular anomalies (convoluted, narrowed arteries, pathological bends, etc.);
• diseases in which there is a narrowing of the arterial lumen (atherosclerotic changes in blood vessels, angiitis and vasculitis, vascular thrombosis and thromboembolism);
• the influence of external causes on the lumen of the artery ( cervical osteochondrosis, mechanical trauma of the spine, curvature of the spine, tumor processes, muscle spasms, scar tissue stretch).

It is worth noting that the syndrome of the left vertebral artery occurs more often than the right one. This is due to the fact that the anatomically left artery emerges from the site of the aortic arch, which most often suffers from atherosclerotic changes. In addition, in this area often there is osteochondrosis, which occurs with dystrophic and degenerative changes in tissues. When osteochondrosis, the arterial vessel is squeezed by bone outgrowths - osteophytes, resulting in a significant deterioration of blood circulation in the brain.

Despite the fact that the syndrome of the right vertebral artery is less common, several of the above reasons can lead to its appearance. In this case, the patient has a marked deterioration in health, which is especially noticeable with sudden movements of the head.

[1], [2], [3], [4], [5], [6], [7], [8]

Pathogenesis

Blood circulation in the brain is carried out due to the flow of blood from four arterial vessels: a pair of common carotid arteries and a pair of vertebrates - left and right.

The main volume of blood flow is passed through the carotid arteries, so most of the stroke states develop due to circulatory disorders in these vessels. Vertebral arteries have a significantly lower capacity, and the violation of blood flow in them does not pose a risk to life, but significantly impairs its quality.

Any expressed change in the movement of blood through the vertebral arteries leads to increasing signs of cerebral hypoxia, which can not but affect its functionality.

[9], [10], [11], [12], [13], [14], [15], [16]

Symptoms of the syndrome of the vertebral artery

The first signs of the vertebral artery syndrome are permanent debilitating headaches, pulsating, localized in the occiput.

With the onset of an attack, pains often affect other areas of the head, for example, in the "forehead" area, or the temporomandibular zone.

Pain in vertebral artery syndrome is present constantly or is increasing with attacks. Often the skin becomes sensitive in the area of the painful area: even a slight touch can cause very unpleasant sensations.

During head movements, a specific crunch is often heard: the patient feels tingling and discomfort in the neck. Sometimes the condition is accompanied by dizziness, dyspepsia, hearing and vision impairment. Some patients also complain of discomfort in the pharynx (feeling of a foreign body), difficulty in swallowing food.

Among the additional nonspecific symptoms should be thirst, a transient feeling of hunger, chills, followed by a heat.

Hearing loss in vertebral artery syndrome begins to manifest with a sensation of noise or ringing in the ears, dizziness. Hearing may decrease in only one ear, depending on the localization zone of circulatory disturbance. At the same time, disorders of the vestibular apparatus are observed.

Syndrome of the vertebral artery in pregnant women

In pregnancy, the load on the spine increases significantly. Moreover, its natural position changes, which entails the tension of the muscles adjacent to the vertebral column. All this in conjunction with the vessels, pinched by the increasing uterus, and affects the appearance of signs of vertebral artery syndrome.

As a rule, after the birth the body gradually comes back to normal, the condition of the spine is also restored, and the manifestations of the syndrome disappear. To accelerate the stabilization of the position of the spine and the removal of muscle spasm, it is recommended to undergo a course of manual therapy, massage and exercise therapy after childbirth.

Stages

In its development, the syndrome of the vertebral artery has two stages.

• Functional (dystonic) stage is characterized by headaches that are constantly present, sometimes increasing with movements or turns of the neck.

In addition, for the stage of dystonia characterized by dizziness, both mild, and severe degree, hearing and vision disorders. Evaluation of the fundus usually indicates a decreased vascular tone.

• With further progression of the vertebral artery syndrome after the dystonic stage comes the following - ischemic. It is characterized by blood flow disorders in the brain, which manifest themselves as transient ischemic attacks. Such attacks are nothing but attacks accompanied by dizziness, coordination disorders, dyspepsia, speech disorders. The attack can begin with another careless movement of the neck. At the end of the attack, the patient becomes weak, weak, he complains of ringing in the ears, flashing of light in the eyes, fatigue, pain in the head.

[17], [18], [19], [20]

Complications and consequences

What is the danger of vertebral artery syndrome? With vertebral artery syndrome, a blood flow disorder occurs in the brain. This can be manifested in the form of violations of speech, consciousness, digestive function.

Progression of the pathological process can lead to a stable functional failure of the stem brain structures. With this development of events, there are sharp bouts of the disease with short-lived fainting conditions (about 10-15 minutes).

The close relationship of nerves passing close to the vertebral artery and the cardiovascular system in pathology can cause myocardial ischemia, and with repeated regular attacks, the infarction can develop.

Syndrome of the vertebral artery is sometimes manifested by the disorder of swallowing processes, which can lead to respiratory dysfunction.

If the vertebral artery syndrome is not treated, then the patient's condition will gradually deteriorate, up to the appropriation of the appropriate disability group.

After the circulatory disorder in the brain, acute ischemia, stroke may occur, the patient becomes disabled and often loses the ability to serve herself independently.

[21], [22], [23], [24], [25], [26], [27], [28], [29]

Diagnostics of the syndrome of the vertebral artery

Often, the diagnosis is established already with a preliminary examination of the patient by a doctor. The doctor probes the painful areas in the back of the neck, checks the amplitude of the movements of the head and observes the reaction of the patient.

In some cases, additional tests are also given. For example, a biochemical blood test can determine an elevated cholesterol level, indicating the presence of atherosclerosis. The analysis of blood coagulability helps to determine hypercoagulability and the body's tendency to increased thrombosis.

Instrumental diagnostics can be expressed in carrying out a radiological examination of the spine. It is especially important to examine the zone from the 1st cervical vertebra to the occipital bone, since this site is the most frequent place of compression of the vertebral artery.

In addition, magnetic resonance imaging is possible. This type of study allows you to determine the presence of hernias, osteophytes, disc protrusions. Additional application of contrast provides visualization of the lumen of the vertebral artery.

Less commonly, ultrasound of the neck vessels, which helps to identify defects inside the vascular lumen.

[30], [31], [32], [33], [34], [35], [36]

Differential diagnosis

Differential diagnosis is carried out with an ordinary migraine, because of the similarity of the clinical picture.

[37], [38], [39], [40], [41], [42]

Treatment of the syndrome of the vertebral artery

Since the syndrome of the vertebral artery is a multisymptomatic disease, it should be treated only in a complex.

Medications that the doctor can use to treat the syndrome, in the first place, should be aimed at removing edema and inflammation from the tissues, as well as the possible expansion of the artery lumen.

	Dosage	Side effects	Special instructions
Baclofen	Take in an amount of 15 to 60 mg per day, in three divided doses.	Sleep disorders, fatigue, shortness of breath, lowering of blood pressure, swelling, urination disorders.	Treatment with the drug begins and ends, gradually increasing and decreasing the dose. Drug can not be abruptly overturned.
Actovegin	Assign 1-2 tablets three times daily before meals. Treatment continues 1-1,5 months.	Fever, dermatitis (including allergic), changes in blood pressure, weakness.	In severe cases, the injection of the drug is used.
Vinpocetine	Take 1-2 tablets three times a day, after meals.	Sleep disorders, stupor, trembling limbs, redness of the conjunctiva, anemia.	The drug is not used in children's practice.
Vazobral	Take ½-1 tablet twice a day. Treatment lasts up to 3 months.	Pain in the abdomen, sleep disorders, indigestion.	Contains caffeine.
Nimesulide	Take 1 tablet twice a day, after eating.	Pain in the abdomen, heartburn, allergies.	It requires caution in the presence of diseases of the digestive system.
Instenon	Can be used in tablets or in injections. Tablets take 1-2 pcs. Up to 3 times a day. Injection drug is administered 1 ml up to 3 times a day for 3-5 days.	Pain in the head, redness of the face.	It is not prescribed for epilepsy.

Vitamins of group B - one of the components of competent treatment of vertebral artery syndrome. Such vitamins as thiamine (B1), nicotinic acid (B3), pyridoxine (B6) and cyanocobalamin (B12) take part in cellular metabolism, stimulate brain neurons, accelerate the transmission of nerve impulses.

In order to improve and facilitate the work of the brain, you can take the following vitamin preparations:

• Milgamma is a neurotropic vitamin remedy, which is often prescribed for pathologies of the nervous and musculoskeletal system. The drug is administered intramuscularly, 2 ml 1 time per day, then every other day. In the period of remission, an alternative use of Milgramam tablets is possible - 1 unit each. Three times a day.
• Neurobion - a combination of neurotropic vitamins, is available in the form of injections and tablets. Injection drug is administered intramuscularly by 1 ampoule daily until the patient's condition is normalized. Tablets take 1 pc. Three times a day, with food.
• Neurovitan is a complex vitamin remedy for the treatment of diseases of the nervous system, arthralgia and myalgia. Usually prescribed from 1 to 4 tablets per day.

Physiotherapeutic treatment is used to accelerate blood circulation, stabilize vascular tone, normalize the CNS and support metabolic processes. Help in the treatment of vertebral artery syndrome can provide such procedures:

• electrophoresis of vasodilator and stimulant drugs, galvanization;
• electrophoresis with vasoconstrictors, contrast procedures;
• darsonvalization;
• electrosleep, franklinization, baths with needles, nitrogen;
• aerotherapy, thalassotherapy;
• transcerebral UHF-therapy.

Massage with vertebral artery syndrome is used as an auxiliary therapeutic agent. During the massage, the brain receives signals that act on the nervous system soothing, which causes the pain to recede. The main method of relaxing anesthetic massage is stroking: with light finger movements, stroking the face, as well as the parietal and occipital region of the head. If other massage techniques, such as kneading or rubbing, are used, the entire session is still ended with relaxing "current" movements.

Manual therapy helps relieve tension in the cervical spine and muscles of the head. This procedure consists of a whole complex of mechanical techniques that calm pain, restore the amplitude of movements in the neck, regulate vascular tone. You should not identify manual therapy with massage, as these are completely different therapeutic effects.

Osteopathy is one of the options for manual treatment, with which you can affect the circulation of cerebrospinal fluid, the quality of blood circulation. The osteopathic doctor effects the various zones of the cranium, particularly on the temples, occiput and lower jaw, applying insignificant pressing movements in time to the operation of the respiratory system.

Acupuncture, in contrast to drugs, allows you to stimulate your own body defense, in which there is a synthesis of special substances that direct all internal forces to fight the disease. This type of treatment is especially relevant in vertebral artery syndrome, since it eliminates muscle spasms, it stops painful sensations. The introduction of the needle absolutely does not cause pain. This procedure is carried out strictly according to the indications and only by a specially trained medical specialist.

Homeopathy is prescribed only after determining the exact causes of the vertebral artery syndrome. Only in this case can we expect a significant benefit from homeopathic medicines.

With constant pain, it is recommended to use dilution C6-C12. Medicines take in the amount of 6 to 8 granules up to 3 times a day. Duration of admission - at the discretion of the doctor, until the condition improves.

• Arnica - helps with pressing pain, brain trauma, and also pain, depending on the position of the head or emotional state.
• Bryonia - suitable for patients with pulsating and twitching pains, which are accompanied by bouts of vomiting and dyspepsia.
• Chamomile - is used to relieve the condition in patients who are particularly sensitive to any pain.
• Kokkulyus - can be used for pain in the occipital region, which are combined with dizziness and sleep disorders.
• Veratrum - will be effective for pains that are accompanied by loss of consciousness, sweating, especially when the head or torso is tilted anteriorly.

Operative treatment is used only in very extreme cases, if the narrowing of the vertebral artery becomes critical and threatens the life of the patient. The use of surgical intervention allows you to directly affect the cause of the syndrome, so the operation can be to remove the tumor, osteophyte, thrombus, or other factor that affects the permeability of the vertebral artery.

Treatment of vertebral artery syndrome at home

Self-treatment of vertebral artery syndrome usually consists in carrying out exercises called isometric: during exercises, the load is on the upper limbs, and the neck and head are immobile at the same time.

One of the exercises is designed to create a lateral tension:

• The palm is placed on the temporal region and begins to be pressed, while the neck should resist;
• is performed first from one, then from the other side.

Similar exercises are carried out when the palm is located on the forehead and on the occiput.

Before the training cycle, you need to know that at first you are allowed some deterioration in the state, which is then normalized.

Alternative treatment

As an alternative treatment, the following popular means can be used:

• Three large garlic heads are cleaned, crushed and left in the refrigerator for three days. After that, juice is filtered, an equal amount of honey and lemon juice are added. The agent drink at night for 1 tbsp. L.
• As often as possible, tea is drunk with the addition of berries and fruits containing ascorbic acid (cranberries, currants, citruses, sea buckthorn, etc.).
• Grate 0,5 kg fresh chestnuts, pour them with water and leave in a cool place for 7 days. The resulting product is filtered and drunk three times a day for 30 minutes before meals for 1 tsp.

Herbal therapy usually successfully supplements traditional therapy. Improve the patient's condition can be, using such variants of recipes:

• Prepare mint infusion of 250 ml of boiling water and 1 full teaspoon of dried mint leaves. Insist 20 minutes. Drink 1/3 cup three times a day for half an hour before meals.
• Take the grass lumbago (2 tsp), pour 250 ml of hot water and insist for the night. In the morning, filter and drink a little throughout the day.
• Prepare infusion of elderberry flowers - 250 ml of boiling water per 1 tbsp. L. Flowers. Insist 30 minutes, filter. Drink infusion with honey, 50-75 ml three times a day before meals.

[43], [44], [45], [46], [47], [48], [49], [50], [51]

Exercises that remove the symptoms of vertebral artery syndrome

Great benefit will be given to exercises aimed at alleviating the symptoms of vertebral artery syndrome. For example, at all stages of the disease you can practice such activities:

• rotation to the right and left of the shoulder joints, kneading the arms of the neck muscles, swinging the arms up and down;
• A free hand hanging with an inclined back and a relaxed neck;
• exercises with a skipping rope and a gymnastic crossbeam, flexing and bending the back;
• swimming.

[52], [53], [54], [55], [56], [57], [58], [59], [60], [61], [62]

Prevention

For preventive purposes it is recommended to perform a number of physical exercises that will strengthen the muscles of the back. To conduct exercises it is enough to give them 5-10 minutes through every hour of work. Such a regimen will help to relax the spasmodic muscles and accelerate blood flow in the vascular bed.

During sleep, a person should feel as comfortable as possible. It is advisable to choose a special physiological orthopedic pillow, which will give the head the most comfortable natural position in a dream.

No less comfortable should be a mattress - its softness should be medium hard.

Once or twice a year, it is recommended to visit a masseur and perform at least 10 massage sessions.

Sanatorium treatment, fresh air, moderate physical activity and rest are also welcome.

Spinal cord syndrome and sports

Patients suffering from the syndrome of the vertebral artery are recommended moderate exercise. Pilates, yoga, swimming, uncomplicated gymnastic exercises are welcome.

Intensive physical activity, as well as professional sports are not recommended. Classes in gyms, fitness clubs and sections should be conducted only under the supervision of a medical specialist.

[63], [64], [65], [66], [67], [68], [69]

Forecast

Is a person suffering from vertebral artery syndrome good for military service in the army?

There is no unambiguous answer to this question, since everything depends on the degree of arterial patency and cerebral circulation disorders.

• If the patient complains of pain in the head, and there are no other signs of the disease, he can be called up for urgent military service.
• If the syndrome is accompanied by vertigo, periodically there are convulsions, and in a history there are confirmed transient ischemic attacks, then such a person may be found unfit for service in the army.

Disability can be attributed only to those patients whose condition is accompanied by transient ischemic attacks, with impaired motor activity and sensitivity, periodic or permanent impairment of vision and hearing, dizziness and loss of consciousness. Such a condition must necessarily be confirmed by the presence of records in the medical history and in the patient's medical record.

In general, the prognosis of the syndrome of the vertebral artery can be considered relatively favorable. If the consequence of the disease becomes a stroke or ischemia, then the patient's condition deteriorates significantly, up to disability. However, even in such patients there are rather high chances of recovery.

With all the prescriptions and recommendations of doctors, the spinal cord syndrome can be transferred to a stable period of remission, in which it is possible to lead a normal life, periodically visiting a doctor to monitor the condition.

[70], [71], [72], [73]