Vertebral arteries depart from the subclavian large vessels. These channels feed the parts of the brain. In particular, the occipital lobes, cerebellum, trunk are supplied with blood. Next, we will analyze in more detail what the vertebral arteries are. The article will describe vascular dysfunctions, the clinical picture and the therapeutic methods used to eliminate them.
General information
Segments of the vertebral artery pass through the canal formed by the transverse processes of the cervical bone elements. For their location, the vessels got their name. Penetrating into the cranial cavity through the foramen magnum, the vertebral arteries merge at the brain stem into the basilar canal. From this area they go up. Branching occurs under the cerebral hemispheres. The right vertebral artery runs on one side and the left vertebral artery on the other.
Anatomy
Each channel is divided into certain parts. The following segments of the vertebral artery are distinguished:
- Intracranial. This section runs along the cranial cavity to the point of confluence of the branches and the formation of the basilar canal.
- Nervous-occipital. This segment runs from the exit of the canal of the processes of the (transverse) vertebrae (cervical) to the entrance to the cranial cavity.
- Neck. This section passes through the canal of the processes (transverse) of the cervical vertebrae.
- Prevertebrate. This is the lowest section. The segment runs from the place of origin of the vertebral vessel from the subclavian to the entrance to the canal of the processes of the cervical vertebrae.
Head blood supply
The brain feeds two pools: vertebrobasilar and carotid. The latter include the carotid arteries (internal). They provide 70 to 85% of the total blood volume. The carotid arteries are responsible for almost all major circulatory disorders of the brain. First of all, this applies to strokes. In this regard, in the process of examination, their condition is given special attention. Their atherosclerotic lesions and their consequences are of great interest to cardiologists, as well as neurologists and vascular surgeons. The vertebrobasilar basin includes both the right and left vertebral arteries. They provide about 15-30% of the total blood volume. An injury such as a stroke can seriously harm a patient, even make them disabled.
Circulatory disorders
The vertebral arteries and their branches feed the cerebellum. With a lack of blood supply, dizziness is likely to occur. This symptom of the vertebral artery is called "vertebrobasilar insufficiency". Through the vessels in question, the brain stem is supplied. In thisstructure concentrated vital centers of respiration and blood circulation. In this regard, a stroke in this area is quite severe and often leads to death. Cervical osteochondrosis is a great danger. The vertebral artery syndrome develops as a result of deformation of the bone elements. Vessels become tortuous, which leads to impaired blood supply.
Causes of violations
Provoking pathological conditions factors can be vertebrogenic and non-vertebrogenic nature. In the latter case, we are talking about injuries that have no connection with the spine. They are caused by congenital anomalies in the size and course of blood vessels or atherosclerosis. But the latter cause is diagnosed infrequently. These anomalies do not have independent significance. But due to the addition of other factors of squeezing the arteries, a very unfavorable condition is formed.
Vertebrogenic lesions are caused by various pathologies of the spine (osteochondrosis - mainly). These disorders can manifest themselves even in childhood or adolescence against the background of dysplastic or post-traumatic instability in the cervical region. As a result, the vertebral arteries can be deformed.
Symptoms of insufficient blood supply
The most characteristic sign of pathology is considered to be constant, in some cases paroxysmal intensifying excruciating throbbing pain in the head. As a rule, it is localized in the occipital zone. During an attack, pain mayspread to other areas. Most often, it gives to the region of the orbit and bridge of the nose, to the parietal-temporal region, to the forehead or ear. Soreness can be both paroxysmal and permanent. Sensations are usually localized on one side.
Scalp pain often occurs. This sensation appears even with a slight touch, combing. When turning or tilting the head, a characteristic crunch may occur, in some cases there is a burning sensation.
In some cases, patients with vertebral artery syndrome develop dizziness, accompanied by nausea or vomiting, hearing loss, tinnitus, and various visual impairments. The latter should include such manifestations as the appearance of a veil or fog before the eyes, double vision, clouding, and others. Rarely, patients complain of a feeling of a foreign body in the throat (pharyngeal migraine) and difficulty swallowing. Among autonomic disorders, there may be a short feeling of hunger, thirst, a feeling of heat or chills.
Sypathetic plexus lesion
In this case, Bernard-Horner syndrome is noted. The condition is usually accompanied by unilateral pain and paresthesia. Symptoms usually capture the face, hard palate, teeth, tongue. A tingling, burning sensation, a feeling of the presence of a foreign body appears in the throat. In addition to these symptoms, there are violations of the vestibular type in the form of dizziness, staggering and falling. Accompanied by these disordersnausea and ringing or noise in the ear. During attacks of headache, chills appear, efficiency decreases, sweating increases, fatigue increases, visual acuity decreases, and "flies before the eyes" appears. With any change in the position of the head, the intensity of pain increases significantly. But at the same time, the patient can find a position in which this sensation is significantly reduced or disappears completely.
Congenital anomaly
This category of pathologies includes hypoplasia. The left vertebral artery is less commonly affected. Signs of pathology are not observed immediately. Symptoms are closely related to hemodynamic disturbances. This means that before congestion and insufficient blood supply become clinically significant, a certain time must pass. At the same time, it should be remembered that compensatory mechanisms operate in the human body, allowing for a certain period to maintain normal nutrition.
Causes of the anomaly
Why does hypoplasia develop? The left vertebral artery can form abnormally in utero for several reasons. The main ones include:
- Bruises, falls of a woman during gestation.
- Prenatal use of alcohol, certain medications, drugs, and smoking.
- Infectious diseases transferred during pregnancy.
- Burdened heredity.
Against the background of hypoplasia, there is a significant narrowing of the lumen of the artery at the site of its entry into the canal leading to the cranial cavity.
Diagnosis
Identification of pathology involves the use of several research methods. First of all, the specialist in his conclusions is based on the clinical picture. In this case, we are talking about information obtained during a neurological examination, as well as patient complaints. Diagnosis often reveals tension of the occipital muscles, difficulty turning the head, pain when pressing on the processes of the 1st and 2nd vertebrae in the cervical region. X-rays are also used during the examination. An MRI is considered mandatory. This procedure allows you to identify the exact cause of circulatory disorders, to detect the area of squeezing the vessel. One of the main diagnostic methods is UZDG (ultrasound dopplerography). During the diagnosis, the specialist must differentiate the syndrome with migraine.
Therapeutic interventions
If blood circulation is disturbed (the vertebral artery is narrowed or deformed), treatment is usually prescribed as a complex one. Therapeutic measures depend on the age of the patient, the severity of the condition, as well as the individual characteristics of the patient. Due to the fact that such patients are at risk of stroke, therapeutic measures are primarily aimed at eliminating circulatory disorders and spasms in the vessels. The complex uses vacuum treatment, pharmacopuncture. Exceptof this, reflexotherapy, taking a number of medications are prescribed. Among the drugs indicated for use are mild antidepressants and anti-inflammatory drugs. Recommended medicines such as "Aminophylline", "Cinnarizine", "Cavinton". For dizziness, the remedy "Betahistine" is prescribed.
In case of detection of circulatory disorders of the brain or spinal cord during the examination, hospitalization of the patient is recommended. In the absence of an urgent need to stay in the hospital, a specialist may recommend temporary wearing of the Shants collar. This corset is used to reduce the load on the cervical region. Against the background of vertebral artery syndrome, manual therapy, physio- and acupuncture, electrophoresis with analgesics, phonophoresis, diadynamic currents are often prescribed.
