Vertebrobasilar Insufficiency

Medically reviewed by Seunggu Han, MD on November 29, 2017Written by Darla Burke on June 29, 2012

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).

What causes 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.

Who’s at risk for VBI?

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

People who have atherosclerosis or peripheral arterial disease (PAD) have an increased risk for developing VBI.

What are the symptoms of 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:

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.

How is VBI diagnosed?

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:

In rare cases, your doctor may also order a spinal tap (also known as a lumbar puncture).

How is VBI treated?

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

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

In some cases, your doctor may recommend surgery to restore blood flow to the back of the brain. Bypass surgery is an option as is an endarterectomy (which removes plaque from the affected artery).

How can VBI be prevented?

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:

What’s the long-term outlook?

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.

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