Vertebro-basilar insufficiency (VBI) with vertigo symptom

Vertigo causes in vertebro-basilar insufficiency (VBI)

The most common in neurological practice cause dizziness is ischemia (reduction of normal blood flow), the posterior parts of the brain (cerebellum, brainstem, visual cortex of the occipital lobe of the brain) due to osteoarthritis of the cervical spine. This course can join an age restriction of the lumen of vertebral arteries atherosclerotic process.

Osteochondrosis of the cervical spine can lead to reflex spasm of the cervical vessels - a vertebral artery and the carotid artery. As a result of this spasm lead to abnormalities in blood supply to the brain structures with bouts of dizziness, noise and ringing in the ears and head, unsteadiness when walking, onmenie face and tongue, etc.

Other factors causing dizziness on the background of vertebro-basilar insufficiency (VBI):

• cervical spine injuries
• syringomyelia
• intoxication (pregnancy)
• multiple sclerosis
• Meniere's syndrome
• acoustic neuroma
• sternocleidomastoid muscle spasm, etc.

Nausea and vomiting can occur in both central and peripheral vertigo — symptoms may be more severe in peripheral vertigo at the onset. In response to provocative maneuvers (such as Barany’s test or the Dix-Hallpike test), peripheral forms of vertigo have a longer latency (2 to 5 seconds) than central forms (short or no latency).

Peripheral vertigo tends to be more position-dependent than central vertigo, and peripheral vertigo is typically associated with a horizontal or rotatory nystagmus, whereas central vertigo is often associated with a horizontal, vertical, or rotatory nystagmus. A downbeat nystagmus is associated with a lesion at the craniocervical junction or cerebellum.

 

Signs and symptoms associated with central and peripheral vertigo

Sign or symptom	Manifestation in central vertigo	Manifestation in peripheral vertigo	Comments
Nystagmus	Horizontal, vertical, or rotatory (toward side of lesion)	Horizontal or rotatory; can be variable (usually away from lesion)	In central vertigo, downbeat is associated with craniocervical junction or cerebellum (e.g., in Chiari malformation) and upbeat is associated with medullary lesions (e.g., in multiple sclerosis).
Response to provocative maneuvers (e.g., as determined by Barany’s test or Dix-Hall pike test)	Short or no latency	Latency 2-5 sec	To measure response, quickly (in <2 sec) bring patient from sitting position to supine position with head turned to one side and eyes open, and observe nystagmus and vertigo for >1 min.
Nausea, vomiting, or both	Variable; associated with increased intracranial pressure	Variable	Nausea and vomiting can occur in patients who have either central or peripheral vertigo, can be more severe in peripheral vertigo at onset, and can often be accompanied by headache in central vertigo.
Ataxia and gait imbalance	Wide-based, ataxic gait	Narrow-based, unsteady gait	CenCentral vertigo i.e., due to cerebellar lesions) causes leaning to one side or the inability to stand or walk.
Cranial-nerve findings (e.g., those pertaining to hearing, swallowing, facial sensation, tongue strength)	Present	Absent	The presence of cranial-nerve findings helps to determine the level of injury in the posterior fossa.
Posture dependency	Sometimes	Usually	Peripheral vertigo tends to be more position dependent than does central vertigo.

 

Vertigo and vertebro-basilar insufficiency (VBI) symptoms diagnosis

Diagnosis of the vertigo symptoms in the background of vertebro-basilar insufficiency (VBI) includes:

• patient's neurological examination
• survey of biomechanics of the cervical spine - muscle tone, range of motion, the position of the vertebrae at rest and movement (X-rays with functional tests)
• Craniocervical vessels Doppler ultrasonography, rheoencephalography (REG), MRI angiography, etc.

Characteristic point for the appearance on the background of vertebro-basilar insufficiency (VBI) of typical complaints of vertigo and the noise in the head and ears - is the patient's age.

 

Vertigo and vertebro-basilar insufficiency (VBI) symptoms treatment

It should be remembered that the adequate treatment of symptoms of dizziness in vertebro-basilar insufficiency (VBI) may be exposed on the dizziness cause (or causes).

Osteochondrosis of the cervical spine and vertebral artery atherosclerosis require a systematic approach in the treatment of:

• manual therapy and massage of the cervical spine
• physical therapy (CMT, UHF, etc.)
• acupuncture
• gymnastics
• cervical collar daily use
• drugs (vascular, nootropic, restorative therapy)

Attention! In the absence of timely treatment of symptoms of dizziness on the background of vertebro-basilar insufficiency (VBI) may develop severe complications such as cerebral ischemia and stroke. In the presence of you or your loved ones signs of ischemia should consult with a doctor.