In the article, we will consider what is the diagnosis of VBN and the consequences of this pathology.
The human brain is supplied with blood according to a certain pattern. Vertebrates are separated from the subclavian arteries located in the upper part of the sternum, which then enter the openings located in the transverse processes of the cervical region and enter the skull. At the base of the cranium, they are included in the basilar artery, which runs in the brain stem, cerebellar and occipital regions of the cerebral hemispheres. Subsequently, the basilar artery is divided into vessels that are responsible for supplying blood to a certain hemisphere of the brain.
If the fullness of blood in the arteries supplying the brain decreases, including due to cervical osteochondrosis, the so-called vertebrobasilar insufficiency or VBN develops. Since the blood supply to the brain becomes insufficient, theagainst the background of the diagnosis of VBN, a deficiency of nutrients and oxygen occurs, which disrupts the proper functioning of the organ, characteristic signs of the disease appear.
Reasons
There are many reasons for the development of the diagnosis of VBN. Young and middle-aged patients suffer from the disease due to external compression of the vertebral arteries due to their compression by growths of bone tissue or osteophytes, as well as disc herniation and spasms of the neck muscles.
In addition, vertebrobasilar insufficiency may occur due to the deformation process in the spinal artery canal against the background of subluxation of the cervical vertebrae. In some cases, the development of VBN is due to such pathological abnormalities as hypoplasia of the vertebral arteries, Kimmerli syndrome and the presence of an additional cervical rib.
Pain spasm
Painful spasm of the vertebral arteries also plays a significant role in the development of the diagnosis of VBN. In the region of the arteries of the spine there are small branches that originate from the autonomic nerves that form the nerve plexus. If the patient has a history of osteochondrosis, pain in the neck can provoke a pathological process in the form of VBN. In addition, due to the pain syndrome, irritation of the vertebral structures and hyperactivation of the sympathetic nerves occur. As a result, innervation of the vertebral arteries occurs, accompanied by a prolonged and sustained spasm.
Diagnosis of NDV in a child and the elderly
In childhood, the appearance of the disease may be due to the anatomical features of the structureof the spine, due to a family history or as a result of birth trauma and traumatic brain injury in infancy.
VBI is diagnosed in many children in neurology.
In old age, vertebrobasilar insufficiency may be the result of atherosclerotic changes in the arteries of the spine. In this case, atherosclerotic plaques form in the lumen of large vessels. The plaque contains a large amount of cholesterol, which clogs the lumen of the artery and disrupts the blood supply to the brain.
In some cases, blood clots occur in the areas of plaque localization, which further block the arterial lumen. The blood supply may also be interrupted as a result of blockage of the artery by a clot formed in another area of the body and passed through the bloodstream into the pool of vertebral vessels. In this case, we are talking about thromboembolism.
VBI is often diagnosed in neurology.
The syndrome can be caused by incorrect medical manipulations, as well as manual therapy and trauma to the spinal region. Another risk factor for the development of the syndrome is stenosis of the subclavian artery, which provides blood supply to the upper limbs.
Against the background of fibromuscular dysplasia, numerous medium-sized arterial stenoses are formed. In some cases, the arteries of the spine are also involved in the pathological process, which leads to the diagnosis of VBN.
Symptoms
Manifestations of vertebrobasilar insufficiency can be quitevaried. Neurological signs of pathology may include visual, vestibular and conduction or sensory disturbances. In addition, with the diagnosis of VBN in neurology, there is a dysfunctional disorder of the nerves located in the skull.
On the part of the musculoskeletal system, VBN is manifested by impaired coordination, as well as central paresis. As a rule, the syndrome is characterized by a combination of dynamic ataxia and intentional tremor in the limbs, as well as reduced muscle tone of an asymmetric appearance.
The severity and combination of various symptoms of VBN is due to the extent of ischemic lesions and their localization, as well as the possibility of collateral circulation.
Sensory disorders are often accompanied by hypo- or anesthesia in one half of the trunk or limb, as well as multiple paresthesias.
In every fourth patient diagnosed with VBN, the symptoms may vary, but almost always there are violations of superficial and deep sensitivity, which is explained by a disorder in the work of the ventrolateral thalamus in the areas of blood supply to the external villous artery in its posterior part. It is far from always possible to detect circulatory disorders in the region of the arteries of the spine, therefore, it is often necessary to additionally use neuroimaging methods.
Visual disturbances in VBN are accompanied by symptoms such as scotoma, cortical blindness, homonymous hemianopsia, and photopsia.
If you were defeatedalso the brain stem, there are disturbances in the work of the nerves of the skull. As a result, facial nerve paresis, bulbar syndrome, and various eye movement disorders are observed.
The listed symptoms, as a rule, appear in combination, however, in exceptional cases, there are single signs, which is explained by the reversible type of ischemia in the system of vertebrobasilar vessels.
Quite often, pathologies of the vertebral arteries associated with a compression crisis in the cerebrovascular system are also associated with sciatica in the neck. Painful palpation and limited cervical mobility are considered signs of this disease. The severity of the pain syndrome increases with turning and tilting the head.
Dizziness and disorder of the autonomic system
Paroxysmal dizziness can also indicate problems with the blood supply to the brain. This phenomenon is due to the high sensitivity of the vestibular apparatus to ischemic symptoms. Dizziness can be mixed or systematic, while the movement is rectilinear, and the patient feels it, both the rotation of the objects around him and his own body.
Another characteristic symptom of VBN stands out - disorders of the autonomic system, accompanied by nausea and vomiting, impaired heart rate, increased blood pressure and severe hyperhidrosis.
In conjunction with other symptoms, hearing impairment can also indicate VBN. This can be both a decrease in the quality of listening, andcongestion, tinnitus. As a rule, such a sign indicates ischemia in the region of the lower anterior part of the cerebellum.
It must be understood that the listed symptoms are also characteristic of other pathologies of the brain and cardiovascular system, so it is important to conduct a complete examination and differential diagnosis to clarify the diagnosis.
Diagnosis
The most important step in diagnosing vertebrobasilar insufficiency is to identify the cause that provoked the development of the pathological process. For this purpose, a detailed neurological examination is carried out, aimed at differentiating the disease from similar pathologies. So, to identify VBI, the following instrumental studies are carried out:
1. Doppler ultrasound allows you to assess the state of blood supply to the vessels of the brain and the main arteries. This method combines duplex scanning and dopplerography, gives an idea of the state of the vertebral arteries.
2. Rheoencephalography in conjunction with infrared thermography also allows you to evaluate the state of the arteries of the brain and spine, but they are less informative than the previous method.
3. Computed and magnetic resonance imaging make it possible to detect the presence of intervertebral hernias, as well as other pathological processes in the spinal column that can lead to the development of VBN.
4. X-ray examination assesses the condition of the cervical spine.
5. Functional tests, performed with extension and flexion, allow you to determine the presence of spondylolisthesis.
In some cases, no less effective diagnostic methods can be such as acoustic stimulation, vestibulological examination, audiometry, etc. Laboratory methods for diagnosing VBN is a blood test for biochemistry and coagulation.
What is the treatment of VBI against the background of cervical osteochondrosis?
Medicated treatment
The choice of a therapeutic regimen directly depends on the degree and nature of vascular damage. Conservative treatment of vertebrobasilar insufficiency includes the following drugs:
1. Antiplatelet agents. The action of this group of drugs is aimed at reducing blood clotting. The use of antiplatelet agents is due to the need to prevent the formation of blood clots. Aspirin is the most common blood thinner. It should be borne in mind that acetylsalicylic acid negatively affects the state of the gastrointestinal tract and can cause hemorrhagic syndrome. It is contraindicated to take with existing pathologies of the gastrointestinal tract, and it is also not recommended to drink pills on an empty stomach.
2. Drugs that dilate blood vessels. They are necessary to prevent obstruction of blood vessels. As a rule, course treatment is required in spring and autumn. The dosage should be increased from the lowest to the optimum therapeutic amount. If monotherapy does not give positive dynamics in the patient's condition, simultaneoustaking several similar medicines.
3. Metabolic and nootropic drugs. The most commonly prescribed are Piracetam, Actovegin, Glycine, Nicergoline, Semax, etc. These drugs are used to stimulate the work of the brain, reduced against the background of VBN in cervical osteochondrosis.
Treatment is not limited to this.
In addition to these drugs, vertebrobasilar insufficiency can be treated with drugs that normalize blood pressure. On an individual basis, painkillers, antidepressants, hypnotics and sedatives, as well as antiemetics and drugs that stop dizziness can be prescribed as additional drugs. The listed drugs contribute to the elimination of symptoms in the diagnosis of VBN in neurology.
Treatment should be comprehensive and timely.
Other treatments
If the course of vertebrobasilar insufficiency is characterized as severe, surgical intervention may be prescribed. The purpose of the operation is to eliminate circulatory disorders caused by VBN. This is done by expanding the basilar and vertebral arteries. In addition, the operation allows you to eliminate compression of the intervertebral discs, relieve tension and stenosis from them. Such manipulations as endarterectomy and microdiscectomy can act as surgical treatment.
Neurologists believe that the treatment of vertebrobasilar insufficiency should take place in a complex. For this reasonpatients with this diagnosis, in addition to drug treatment, are prescribed special therapeutic exercises, as well as physiotherapy.
In addition, VBI is treated using the following methods:
1. Therapeutic massage aimed at improving blood circulation.
2. Visiting a chiropractor.
3. Acupuncture and reflexology to relieve muscle spasms.
4. Hirudotherapy. Almost all vascular diseases can be eliminated with leeches as an additional method of treatment.
5. Magnetotherapy. Favorably affects the circulatory system.
6. Wearing a special corrective corset around the neck.
Timely and correct treatment of VBI against the background of cervical osteochondrosis allows you to completely eliminate the disease. Otherwise, the risk of pathology becoming chronic increases, as well as a significant deterioration in the quality of life of the patient.
Forecast
Prognosis for vertebrobasilar insufficiency is made on the basis of the severity and nature of the disease of the cardiovascular system that caused this syndrome, as well as the degree of arterial damage and the possibility of establishing a bypass blood supply to the brain.
If the arteries show a tendency to narrow more, and the correct therapy has not been carried out in a timely manner, the risk of developing irreversible consequences and complications increases. Such patients are prone to stroke, as well as dyscirculatory type encephalopathy against the background of a stable neurological deficit.
Auspiciousthe prognosis for VBI is possible only in the case of a satisfactory assessment of the state of the cerebral vessels, as well as with the right treatment against the background of a mild pathology.
Prevention
Mandatory preventive measures for NDV are:
1. Stop smoking, drinking alcohol and drugs.
2. Regular monitoring of blood pressure.
3. Compliance with a special diet. Sweet pastries, s alt, spicy and spicy foods, marinades and canned food are subject to restriction. Recommended foods for NDV are seafood, fruits and vegetables, low fat dairy products.
4. The presence of moderate physical activity of moderate intensity.
In some cases, the above measures are enough to stop the disease even in the absence of medical and physiotherapeutic support.
If the disease was detected at the initial stage of its development, treatment is carried out on an outpatient basis. With a later detection of the pathological process, hospitalization is recommended. This is done to prevent the development of a stroke.
We covered the symptoms and treatment of NDV.
