In the list of he alth disorders associated with cervical osteochondrosis, a special place is occupied by the so-called vertebrobasilar syndrome. Particular because, along with other cerebrovascular disorders, this pathology not only reduces the patient's quality of life, but, if not treated in a timely manner, can pose a serious threat to the patient's he alth and well-being.
What is vertebrobasilar syndrome?
Syndrome of the vertebral artery in cervical osteochondrosis is a complex of disorders resulting from hemodynamic disturbances in the basin of the vertebral artery. This condition is one of the complications of cervical osteochondrosis, which, due to the specific anatomical features of the vertebral artery, can lead to a disruption in the functioning of almost all organs and systems.
Close attention to this pathology is due to the fact that, in addition to subjective discomfort (pain, dizziness, vision problems), vertebrogenic syndrome can negatively affect the vital functions of a number ofstructures of the central nervous system, which causes conditions that threaten he alth and life.
Causes of occurrence
The reasons for the development of this pathology lie in the anatomical features of the cervical spine and in particular the artery itself. This paired vessel is a branch of the subclavian artery. Approaching the sixth cervical vertebra, the vertebral artery enters the canal formed by the processes of the cervical vertebrae (from the first to the sixth). From this canal, the vertebral artery enters the skull.
Laying in the bone canal, the vertebral artery is subject to deformation at the slightest instability of the cervical vertebrae, as well as with a decrease in the height of the intervertebral discs.
Mechanisms for the development of vertebrogenic syndrome:
- Due to the deformation of the artery, the volume of blood flow through it decreases, which leads to a violation of the blood supply to the basal structures of the brain.
- Another mechanism for the development of pathological symptoms associated with cervical osteochondrosis is irritation or even infringement of the sympathetic nerve bundle that runs along with the vertebral artery. Injury to nerve fibers and leads to the rapid development of neurological symptoms.
This is how a pathological symptom complex is formed, better known as the vertebral artery syndrome on the background of cervical osteochondrosis.
Risk factors
There are a number of conditions that are more likely to cause vertebral artery syndrome in cervical osteochondrosis (causesthe occurrence of the disease lies in the pathology of the spine), these are:
- Osteochondrosis itself.
- Overweight characteristic of obesity.
- Systemic diseases accompanied by metabolic disorders (diabetes mellitus, atherosclerosis).
- Excessive emotional stress and physical activity.
- Systemic toxic effects (alcohol, nicotine).
- Genetic predisposition to vascular disorders.
Clinical manifestations
The symptoms of this vascular pathology are very recognizable:
Severe paroxysmal headaches, characterized by a pulsating character and spreading from the back of the neck to the back of the head, and from there - towards the temples and frontal region. More often headache in vertebrogenic syndrome has unilateral localization.
- Painful sensations localized directly on the surface of the scalp.
- Vestibular Disorders: feeling unsteady both while walking and at rest, swaying, episodes of dizziness, hearing loss, audibility of extraneous sounds in the form of ringing or noise in the ears. "Floating away from under the feet" with sharp turns of the head.
- Subjective decrease in visual acuity due to flashing before the eyes of sparks, flies, fog or shroud, feeling of sand in the eyes.
- Tension and soreness of the neck muscles (especially on palpation).
- Episodes of numbness in any part of the face.
- Disturbances in the cardiovascular sphere in the form of episodes of tachycardia, pain behind the sternum, feeling of lack of air during inspiration.
- Psychological manifestations in the form of attacks of aggression, panic attacks, depressive states or a tendency to apathy.
In addition to high blood pressure, which often accompanies vertebral artery syndrome in cervical osteochondrosis, the main symptoms of this vascular disorder in severe cases may be accompanied by the following symptoms:
- Nausea that occurs at the height of the attack and ends in vomiting.
- Crackling and crunching when making movements in the cervical region - tilting and turning the head.
- Intensification of pathological phenomena from the side of vision: double vision, narrowing of the field of vision, fuzzy visibility.
- Progression of hearing loss and increased pathological noises.
- Disorder of the act of swallowing.
- Deterioration of the sensitivity of the skin of the lips, mucous membrane of the tongue and pharynx; numbness and paresthesia in these areas.
- Loss of consciousness. Often this condition is preceded by a tilted back position of the head (as, for example, when looking up). Approaching loss of consciousness can be recognized by increased nausea and dizziness, impaired speech, sudden loss of vision in one of the eyes.
These signs, combined with soreness and other signs of exacerbation of cervical pathology, are practicallyunmistakably point to the syndrome of the vertebral artery in cervical osteochondrosis.
Diagnosis
Variety of subjective signs of vertebrogenic syndrome and different perception of complaints by different patients significantly complicates the diagnosis of vertebrobasilar syndrome. In this regard, a list of mandatory examinations was developed to identify objective signs characteristic of this pathology.
- Duplex scanning or Doppler ultrasound of the arteries to detect extravasal deformities of the vertebral artery.
- X-ray of the cervical vertebrae using functional tests and image fixation during flexion and extension of the cervical spine.
MRI (Magnetic Resonance Imaging), which reveals the presence, extent and localization of blood vessel deformities
Vertebral artery syndrome in cervical osteochondrosis is diagnosed when three main clinical criteria are identified in a patient:
- The presence of a set and combination of symptoms characteristic of this pathology.
- Typical changes detected using magnetic resonance imaging and neck x-rays.
- Characteristic disorders detected during scanning, as well as in the course of dopplerography of the vertebral arteries using stress tests, during flexion and extension of the head.
This list of diagnostic criteria was established to avoid overdiagnosis of vertebrogenic syndrome.
Importance of differentialdiagnostics
Sharp attacks of headaches in combination with dizziness and nausea against the background of rising blood pressure, as well as the likelihood of loss of consciousness may indicate both in favor of a stroke in the vertebrobasilar basin, transient ischemic attack or infectious-toxic damage to the nervous tissue during neuroinfection and to detect vertebral artery syndrome in cervical osteochondrosis. Symptoms come on suddenly, making it difficult to take an anamnesis. Both conditions are classified as urgent and are an indication for hospitalization and a detailed examination.
Differential diagnosis is necessary for the correct selection of treatment for each of the listed diseases.
Drug therapy
In case of vascular pathology, which includes the syndrome of the vertebral artery in cervical osteochondrosis, treatment must necessarily be comprehensive and affect not only the etiology, but also focus on the correction of disorders resulting from circulatory disorders.
- The first step in medical treatment is the selection of non-steroidal anti-inflammatory drugs to eliminate neurogenic inflammation. Priority is given to drugs from the group of NSAIDs of the selective type, blocking only the second type of cyclooxygenase enzyme; this approach combines effectiveness in disease control with safety for the patient. Typical representatives of this group of drugs are products based on nimesulide, meloxicam or celecoxib.
- A number of disorders that cause symptoms in vertebrogenic syndrome develop under the influence of pathological hypertonicity of the neck muscles. This is one of the signs that we have a vertebral artery syndrome with cervical osteochondrosis. Patient reviews indicate that the inclusion of muscle relaxants in the treatment regimen contributes to a more rapid normalization of well-being and general condition. From the group of such drugs, Mydocalm, Sirdalud, Baclofen give a good effect. Eliminating muscle spasm, muscle relaxants reduce the intensity of pain, thereby reducing the need for non-steroidal anti-inflammatory drugs. Important point! During the period of use of these drugs, you should refrain from activities that require increased attention and quick reactions. In addition, such work is incompatible with vestibular disorders, which manifest vertebral artery syndrome in cervical osteochondrosis.
- Treatment of conditions caused by hemodynamic failure in the vertebrobasilar basin is unthinkable without the use of agents that normalize microcirculation, bioactive substances and other drugs, the action of which is aimed at combating tissue hypoxia.
Physical Methods
As an independent treatment technique, physiotherapy is not effective enough; vertebral artery syndrome in cervical osteochondrosis requires an integrated approach to treatment. However, as an aid to physiotherapy, it gives quite good results.
The disadvantage of the method can be considered that its applicationcontraindicated during an exacerbation of osteochondrosis.
Massage with vertebrogenic syndrome is often contraindicated even during remission, as it can cause displacement of the vertebrae and infringement of the neurovascular bundle.
The preferred method for this pathology is reflexology, which can relieve muscle spasms without harming the patient and without aggravating his condition.
Of no small importance is the orthopedic regimen (immobilization of the cervical region by wearing the Shants collar). This moment is especially important in cases where the deterioration of the patient's condition is associated with a change in the position or movements of the head.
Outside of exacerbation, it is necessary to take a set of measures to strengthen the muscular frame of the neck. Due to the specifics of the pathology, the decision on the advisability of exposure through massage or exercise therapy should be made by a specialist. Exercises should also be performed under the supervision of a specialist.
Folk methods
Among the recipes containing folk experience in the treatment of certain disorders, there are also remedies that help to cope with some manifestations of vertebrogenic syndrome.
- The use of garlic to reduce blood viscosity. To obtain a medicinal composition, three large heads of garlic must be crushed and kept in the dark for three days. Then the mass must be filtered and added to it in equal amounts of honey and lemon juice. Drink before bedtablespoon.
- Reducing blood pressure will help to take a composition prepared from 40 grams of corn stigmas, 20 grams of lemon balm, lemon juice and a glass of boiling water. After an hour of infusion, take half a glass three times a day 30 minutes before meals.
It should be remembered: in such a serious situation as the vertebral artery syndrome with cervical osteochondrosis, the causes of the disease and numerous disorders are not eliminated by herbal infusions or other folk remedies. A complete treatment regimen can only be prescribed by the attending physician after a detailed examination of the patient. Folk remedies are used as auxiliary; their use is permitted under the following conditions:
- No allergic reactions to ingredients.
- No contraindications and doctor's approval.
Indications for surgical treatment
The decision on surgical intervention is made in case of development due to the vertebrogenic syndrome of the following pathological conditions:
- Ischemic attacks, strokes.
- Intellectual-mnestic, cognitive disorders.
- Rapid progression of vision, hearing and balance disorders.
In addition, cases are recognized as indications when the syndrome of the vertebral artery in cervical osteochondrosis is combined with severe arterial hypertension, anatomical anomalies of the vertebral artery or atherosclerosis, as well as the ineffectiveness of therapeutic measures.
Complications
The most formidable complicationvertebrobasilar syndrome is a stroke in the vertebrobasilar basin. Its consequences can be:
- Disappearance of hearing.
- Complete loss of vision.
- Heart failure.
- Respiratory failure.
