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 in any artery in your body, including 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. Over time, plaque can severely narrow and completely block your arteries, preventing blood from reaching your vital organs.
When the blood flow in the arteries of your vertebrobasilar system is significantly reduced, this condition is known as vertebrobasilar insufficiency (VBI).
VBI occurs when the flow of blood to the back of your brain is reduced or stops. According to research, atherosclerosis is the most common cause of the disorder.
Risk factors for the development of VBI are similar to those associated with developing atherosclerosis. These include:
- hypertension (high blood pressure)
- being over the age of 50
- family history of the disease
- elevated levels of lipids (fats) in the blood, also known as hyperlipidemia
People who have atherosclerosis or peripheral arterial disease (PAD) have an increased risk for developing VBI.
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 or vertigo
- numbness or tingling in the hands or feet
- nausea and vomiting
- slurred speech
- changes in mental status, including confusion or loss of consciousness
- sudden, severe weakness throughout your body, which is called a drop attack
- loss of balance and coordination
- difficulty swallowing
- weakness in part of your body
The symptoms can come and go, as in a transient ischemic attack (TIA).
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.
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 blood vessels at the back of your brain
- magnetic resonance angiography (MRA)
- blood tests to evaluate clotting ability
- echocardiogram (ECG)
- angiogram (X-ray of your arteries)
In rare cases, your doctor may also order a spinal tap (also known as a lumbar puncture).
Your doctor can recommend several different treatment options depending on the severity of your symptoms. They’ll 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
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:
The outlook for VBI depends on your current symptoms, health conditions, and age. Younger people 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.