The vertebral artery is a pair formation, starting from the subclavian artery( on the right it departs from the brachiocephalic trunk, and to the left - from the arch of the aorta) and terminates in the transverse aperture 6 of the cervical vertebra. This artery passes through the overlying cervical vertebrae and enters the cavity of the skull by means of a large occipital opening.30-35% of arterial blood enters the brain with the help of two vertebral arteries. If they are squeezed, then there is a syndrome of the vertebral artery. Blood enters the posterior parts of the brain: the trunk and back of the cerebral cortex. The fact that the blood flow to the brain is carried through the vertebral artery largely explains why the syndrome has characteristic symptoms.
During its course, the vertebral arteries also contact the soft tissues that surround the vertebral column. That is why the mechanisms of the development of the disease differ.
Table of contents:
- Causes of the disease
- Symptoms of
- Diagnosis of the disease
- Treatment of
Causes of the disease
There are quite a few reasons that cause this syndrome. All of them can be divided into groups:
Causes associated with the spine.
Scoliosis of the cervical spine, trauma, congenital connective tissue dysplasia lead to degenerative-dystrophic processes in the spine. These processes attract vertebrogenic vertebral artery syndrome.
Causes not related to the spine. Atherosclerosis of the vertebral artery.
Atherosclerotic processes in the vertebral artery, congenital anomalies of the location of vessels or their structure cause a non-vertebral syndrome of the vertebral artery.
As a rule, the syndrome develops on the left side. This can be explained as follows. First, the vessel flows directly from the arc, which is why the arteriosclerosis of the vessel is quite common. Secondly, on the left side there is often an additional( additional) cervical rib.
And other reasons:
- arthrosis( degenerative-dystrophic process) of the intervertebral joint, which connects the second and first cervical vertebrae;
- Kimmery's anomaly is the formation in the development of the fetus of the additional cervical rib;
- atypical branch of the vertebral artery from subclavian( usually developing from the left);
- too high position of the tooth-like process from the axial, that is, the second cervical vertebra;
- spasms of the muscles of the neck.
In addition to the reasons, the factors that themselves cause the syndrome, but contribute to its development, are also singled out. Thus, sharp slopes or turns of the head may well become those factors that cause the syndrome to develop. At sharp inclinations and turns one-sided compression of a vessel develops, which together with other factors leads to a decrease in the elasticity of the vascular wall.
Syndrome is expressed in a peculiar way, so patients note the following symptoms:
- excruciating headache.
It can be stinging or pulsating, spreading to the temple, crown or brow region. Peculiarity: pain is localized either in the right or left side of the head. The pain persists the patient constantly, but is especially intensified during walking or during sleep, if the position of the head or body predisposes to it. Much less often the pain is paroxysmal. Often patients say that the pain has stopped, but they could not find a logical explanation for this. The reason is the position of the head. But there are no general rules about what the position of the head should be, so that the pain disappears;
- visual impairment( decreased acuity, sensation of sand in the eyes, a veil in the eyes) or pain in the eyeballs;
- auditory or vestibular disorders, for example, dizziness, loss of stability, noise in one ear, hearing loss;
- cardiac manifestations, if a person has cardiovascular diseases, for example, hypertensive heart disease, ischemic.
Do not exclude and compressing or pressing pain behind the sternum, increased blood pressure. If the disease progresses, then transient ischemic attacks may occur. How to recognize an approaching attack? Complete or partial loss of vision, sensory motor disorders, difficulty swallowing, speech disorders and coordination of movements - that's the whole set of symptoms.
After finding these symptoms, you should immediately consult a doctor. Symptoms that describe the syndrome are similar to manifestations of cerebral circulation disorders.
Diagnosis of the disease
Diagnosis of vertebral artery syndrome involves several different studies. First of all, the diagnosis is based on those data that can be obtained from the clinical picture of the disease. It is about the patient's complaints, as well as about the information that the doctor received during the neurological examination.
Quite often, diagnostics can detect the tension of the occipital muscles, the presence of difficulty in turning the head, pain when pressing on the processes of the first and second cervical vertebrae.
In addition, diagnosis means the compulsory conduct of:
- Radiographic examination performed for the cervical spine. Here the diagnosis is carried out in the main, as well as additional projections and allows, ultimately, to identify those or other changes that occurred in the state of the atlanto-occipital joint. There are changes that can cause compression of the vertebral artery;
- Dopplerographic study of blood flow. Such diagnostics is carried out according to the system of vertebral-basilar arteries and allows to detect the presence of a sharp obstruction of the arterial blood flow or its violation;
- MRI.Tomography of the brain is an obligatory study, conducted in the presence of suspicion of the possibility of developing ischemic stroke. MRI allows you to determine the true cause that caused the violation of blood flow, as well as to detect the site of compression of the vertebral artery. MRI of the spine( more precisely, of its cervical region) is also performed, which makes it possible to detect any pathology of the spinal column.
Only qualitatively carried out diagnostics will allow to start treatment in time, clearly aimed at eliminating the syndrome of the vertebral artery. In this regard, diagnostics are especially important for the reason that it helps to identify the true factor that caused the disease.
If suddenly there is a suspicion that the blood circulation in the brain will be disturbed, the patient is immediately hospitalized.
When referring to treatment, its specific methods, mention should be made of the following treatment measures. It is noteworthy that the choice of one or another method depends on the cause and level of compression of the vertebral artery. So, the treatment can provide:
- Wearing an orthopedic corset, which will reduce the burden on the cervical spine, as well as limit its mobility. Corset in each case is selected individually;
- Conducting manual therapy, as well as massage the collar zone. Treatment manual therapy is designed to restore the normal anatomical position of all structures of the spine, but its conduct requires a preliminary examination with a neurologist. The fact is that such treatment has some contraindications;
- Purpose acupuncture. This treatment is especially effective in that it reduces the intensity of the pain syndrome, and also eliminates discomfort in the heart and dizziness;
- Physiotherapy. It includes several methods at once. These include electrophoresis with analgesic agents, magnetotherapy, phonophoresis with hydrocortisone, and the use of dynamic currents;
- Selection of an individual complex of exercises within the framework of therapeutic physical training. LFK is aimed at strengthening the muscle corset. This treatment involves several general recommendations. Thus, patients should subsequently use only comfortable bedding.
It should also be noted the availability and drug treatment methods, which involve the treatment of the disease that caused the syndrome. Appointed to receive analgesics, non-steroidal anti-inflammatory drugs. In some cases, drugs are prescribed, the effect of which improves cerebral blood flow.
In the most severe cases, the syndrome of the vertebral artery involves performing operations that are aimed at decompressing the vertebral artery that has undergone compression.
- Ischemic cerebral stroke
- Hypoplasia of the left vertebral artery
- Pain in the sternum in the middle of the symptoms