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Vertebrobasilar insufficiency
Last reviewed: 23.04.2024
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Vertebro-basilar insufficiency is a process of impaired brain function associated with decreased blood supply.
Causes of the vertebrobasilar insufficiency
- Disrupted blood supply to the brain.
- Atherosclerosis of cerebral vessels.
- High blood pressure.
- Arterial disease (stratification, squeezing, thrombosis).
- Congenital pathologies of vascular development.
- Compression of the arteries of the spine due to cervical pathologies.
- Damage to the small arteries of the brain (as a result of diabetes).
[Symptoms of the vertebrobasilar insufficiency
The signs of the disease can be very variable. One of the most common and bright symptoms is a sharp, spontaneous dizziness. It can last from a few seconds to several hours. The accompanying signs are a feeling of nausea, which can be accompanied by vomiting, sweating, a violation of the rhythm of heartbeats and instability of blood pressure. There are cases when, along with dizziness and other symptoms, the patient feels like falling into the abyss, or crouching. Disturbances in motor activity are manifested in a decrease in the physical strength of the limbs. There are cases of damage to sensitive nerve cells of the inner ear, auditory nerve and central formations of the auditory system.
Diagnostics of the vertebrobasilar insufficiency
The vertebrobasilar insufficiency is diagnosed by a neurologist on the basis of the general anamnesis of the disease. After finding out the reasons causing this pathology, treatment can be prescribed. For the examination, the ultrasound dopplerography of the vessels is used - this is absolutely painless procedure that does not cause side effects, does not contain radiation and is suitable for all patients. It is aimed at the study of blood vessels and analysis of blood circulation parameters in them. Also, at the examination, functional tests are performed with hyperventilation to assess the blood supply to the brain. This method involves several quick breaths and exhalations for thirty to forty seconds, after which the electrocardiogram parameters are immediately recorded and compared with the baseline values.
If the pulse beat is increased by fifty to one hundred percent and negative teeth are seen in the ECG results, the sample can be considered positive. The patient is also assigned to the x-ray of the spine (neck area), computer or MR-tomography. It is also possible to use the method of infrared thermography and rheoencephalography (are the least informative). The method of MR-angiography allows you to obtain the necessary information without intravenous manipulation. A biochemical blood test is also prescribed.
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Treatment of the vertebrobasilar insufficiency
The main treatment for vertebro-basilar insufficiency is appointed based on the nature of the vascular lesion. As part of complex therapy, the patient is prescribed a therapeutic diet with a reduced intake of salt, a daily check of blood pressure indicators is required, the patient should give up nicotine and alcohol, excessive physical exertion. If positive results are not observed after a few months (from three to six), treatment with medications is prescribed. Among them are diuretics, angiotensin converting enzyme inhibitors, calcium channel blockers - amlodipine preparations, felodipine, captopril, enalapril, beta blockers - atenolol, metoprolol, bisoprolol. The choice of drugs and their combination is selected in each case individually by the attending physician.
If vertebrobasilar insufficiency is a consequence of atherosclerosis, it is possible to use drugs with an antithrombotic effect, for example, acetylsalicylic acid (a daily dose of 50-100 mg), dipyridamole (the daily dose may range from 75 to 225 mg depending on body weight), clopidogrel (75 mg / day), ticlopidine (0.25 g twice daily during meals). The drug nicergoline is able to exert spasmolytic influence on the vascular periphery and the arteries of the brain, also leads to a decrease in the tone of the pulmonary and cerebral arteries, improves blood flow. Take 10 mg 3 times a day.
Cinnarizine has a positive effect but cerebral circulation, improves microcirculation, reduces the excitability of brain structures. Usage: 25 mg 3 times a day or 75 mg (1 capsule) once a day. Assign also pyrocetam, cerebrolysin, fesam, intravenously inject carnitine hydrochloride (8-12 times). The drug betahistine is used to get rid of attacks of dizziness, appointed for a long time (2-3 months) for 8-16 mg 3 r / d. A drug such as meclosin is also capable of reducing the frequency of dizziness and eliminating current symptoms such as nausea and vomiting.
Forecast
The prognosis for such a disease as vertebro-basilar insufficiency depends on the nature and severity of the underlying pathology. With a progressive process of narrowing the arteries and stable arterial hypertension, there is a threat of a stroke. If the disease occurs without complications, with competent and timely treatment, the outcome of the disease is positive.