Vertebrobasilar Insufficiency

What Is Vertebrobasilar Insufficiency?

The vertebrobasilar arterial system is located at the back of your brain and includes the vertebral and basilar arteries. These arteries supply blood, oxygen, and nutrients to vital brain structures, such as your brainstem, occipital lobes, and cerebellum.

A condition called atherosclerosis can reduce or stop blood flow through the vertebrobasilar system. Atherosclerosis is a hardening and blockage of the arteries. It happens when plaque that’s made up of cholesterol and calcium builds up in your arteries. The buildup of plaque narrows your arteries and reduces blood flow. Plaque can completely block your artery over time, preventing blood from reaching your vital organs. This can occur in any artery in your body. When it occurs in the arteries of your vertebrobasilar system, it reduces blood flow to structures in the back of your brain. This condition is known as vertebrobasilar insufficiency (VBI).

What Causes VBI?

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VBI occurs when the flow of blood to the back of your brain is reduced or stops. According to Nebraska Medical Center, atherosclerosis is the most common cause of the disorder.

Who Is at Risk for VBI?

Risk Factors

Risk factors for the development of VBI are similar to those associated with developing atherosclerosis. These include:

  • smoking
  • high blood pressure (hypertension)
  • diabetes
  • obesity
  • being over the age of 50
  • family history of the disease
  • elevated lipids, or fats, in the blood (known as hyperlipidemia)

People who have atherosclerosis or peripheral artery disease also have an increased risk for developing VBI.

What Are the Symptoms of VBI?

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The symptoms of VBI vary depending on the severity of the condition. Some symptoms may last for a few minutes, and some may become permanent. Common symptoms of VBI include:

  • loss of vision in one or both eyes
  • double vision
  • dizziness (vertigo)
  • numbness or tingling in the hands or feet
  • nausea and vomiting
  • slurred speech
  • changes in mental status, including confusion
  • sudden, severe weakness throughout your body, which is called a drop attack
  • loss of balance and coordination
  • difficulty swallowing
  • weakness in part your body

The symptoms of VBI are similar to those of a stroke. Seek emergency medical care if you experience these symptoms. Immediate medical intervention will help increase your chance of recovery if your symptoms are the result of a stroke.

How Is VBI Diagnosed?

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Your doctor will perform a physical exam and run a series of tests if you have symptoms of VBI. Your doctor will ask you about your current health conditions and may order the following tests:

  • CT or MRI scans to look at the vessels at the back of your brain
  • magnetic resonance angiography (MRA)
  • blood tests to evaluate clotting ability
  • an echocardiogram
  • an X-ray of your arteries, which is called an angiogram

In rare cases, your doctor may also order a spinal tap, or lumbar puncture.

How Is VBI Treated?

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Your doctor can recommend several different treatment options depending on the severity of your symptoms. They will also recommend lifestyle changes, including:

  • quitting smoking if you smoke
  • changing your diet to control cholesterol levels
  • losing weight if you’re overweight or obese
  • becoming more active

Additionally, your doctor may prescribe medications to help reduce your risk of permanent damage or stroke. These medications may:

  • control blood pressure
  • control diabetes
  • reduce cholesterol levels
  • thin your blood
  • reduce coagulation of your blood

In some cases, your doctor may recommend surgery to restore blood flow to the back of the brain. Bypass surgery or an endarterectomy are also options. An endarterectomy removes plaque from the affected artery.

How Can VBI Be Prevented?

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Sometimes VBI can’t be prevented. This can be the case for those who are aging or those who’ve had a stroke. However, there are steps that reduce the development of atherosclerosis and VBI. These include:

  • quitting smoking
  • controlling blood pressure
  • controlling blood sugar
  • eating a healthy diet that’s rich in fruits, vegetables, and whole grains
  • being physically active

What Is the Long-Term Outlook?

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The outlook for VBI depends on your current symptoms, health conditions, and age. Younger patients who experience mild symptoms and control them through lifestyle changes and medication tend to have good outcomes. Advanced age, frailty, and strokes can negatively affect your outlook. Discuss strategies and medications with your doctor to help prevent VBI or lessen its symptoms. 

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