Vertebral arteries. Syndrome of the vertebral artery: symptoms, diagnosis, treatment
Vertebral arteries move away from subclavianlarge vessels. These channels nourish the brain. In particular, blood is supplied to the occipital lobes, the cerebellum, and the trunk. Next, let us examine in more detail what vertebral arteries are. The article will describe violations of the functioning of the vessels, the clinical picture and therapeutic methods used to eliminate them.
Segments of the vertebral artery pass through the canal,Formed by transverse processes of the cervical bone elements. For their location of the vessels and received the name. Penetrating into the cranial cavity through the occipital opening, the vertebral arteries merge at the brainstem into the basilar canal. From this site they pass upwards. Under the cerebral hemispheres, branching occurs. On the one hand passes the right, and on the other - the left vertebral artery.
Each channel is divided into specific parts. The following segments of the vertebral artery are distinguished:
- Intracranial. This site passes through the cavity of the skull to the point of confluence branches and the formation of a basilar canal.
- Cervico-occipital. This segment extends from the exit from the canal of the processes (transverse) vertebrae (cervical) to the entrance to the cranial cavity.
- Cervical. This site passes through the canal of the processes (transverse) of the vertebrae of the cervical region.
- Pericular. This is the lowest part. The segment extends from the site of the vertebral vascular withdrawal from the subclavian to the entrance to the canal of the processes of the vertebrae of the cervical region.
Blood supply to the head
The brain feeds two pools: vertebrobasilar and carotid. The latter include carotid arteries (internal). They provide 70 to 85% of the total blood volume. Sleepy arteries respond almost to all major circulatory disorders of the brain. This primarily applies to strokes. In this regard, during the survey, their condition is given special attention. Their atherosclerotic lesions and the consequences of this are an object of increased interest of cardiologists, as well as neurologists and vascular surgeons. The vertebrobasilar pool includes both the right and left vertebral arteries. They provide about 15-30% of the total blood volume. Such a defeat as a stroke can seriously harm a patient, even make him disabled.
Disorders of blood supply
Vertebral arteries and their branches feedcerebellum. With a shortage of blood supply, dizziness is likely. This symptom of the vertebral artery is called "vertebrobasilar insufficiency." Through the vessels in question, the supply of the brain stem is provided. In this structure, the vital centers of respiration and circulation are concentrated. In this regard, the stroke in this area is quite difficult and often leads to death. Cervical osteochondrosis is a great danger. Syndrome of the vertebral artery develops due to deformation of bone elements. Vessels become tortuous, which leads to a violation of blood supply.
Causes of violations
Provoking pathological factors factorscan be vertebrogenic and non-bred in nature. In the latter case, we are talking about injuries that do not have a connection with the spine. They are caused by congenital anomalies in the size and course of the vessels or atherosclerosis. But the last reason is not diagnosed infrequently. These anomalies do not have an independent meaning. But in connection with the addition of other factors of compression of the arteries, a very unfavorable condition is formed.
Vertebrogenic lesions are caused by differentpathologies of the spine (osteochondrosis - mainly). These disorders can occur even in childhood or adolescence against a background of dysplastic or post-traumatic instability in the cervical region. As a result, vertebral arteries can be deformed.
Symptoms of circulatory insufficiency
The most characteristic sign of pathology isconstant, in some cases, paroxysmally aggravating painful throbbing pain in the head. As a rule, it is localized in the occipital zone. During the attack, soreness can spread to other areas. Most often she gives in the eye and nose, in the parietal-temporal area, to the forehead or ear. Soreness can be either paroxysmal or permanent. The sensations are usually localized on one side.
Often there is soreness of the scalp. This sensation appears even with a slight touch, combing. When turning or tilting the head, a characteristic crunch may occur, in some cases, burning occurs.
In a number of cases in patients with vertebral syndromearteries appear dizziness, accompanied by nausea or vomiting, hearing loss, ringing / noise in the ears, various visual impairments. The latter include such manifestations as the appearance of a veil or fog before your eyes, doubling, clouding, and others. Rarely patients complain of a sense of presence in the throat of an alien body (pharyngeal migraine) and difficulty in swallowing. Among vegetative disorders, there may be a brief feeling of hunger, thirst, a feeling of heat or chills.
Sympathetic Plexus Symptom
In this case Bernard-Horner syndrome is noted. The condition is accompanied, as a rule, by unilateral pain sensations and paresthesias. Symptoms usually involve a person, a hard palate, teeth, and tongue. In the throat, a tingling, burning sensation, a sense of the presence of an alien body appears. In addition to these symptoms, there are violations of the vestibular type in the form of dizziness, staggering and failure. These disorders are accompanied by nausea and ringing or noise in the ear. In the course of attacks of headache, chills appear, working capacity decreases, sweating increases, fatigue increases, visual acuity decreases, and "flies before the eyes" appear. With any change in the position of the head, the intensity of soreness is greatly increased. But at the same time the patient can find a position in which this sensation decreases substantially or disappears completely.
This category of pathologies includes hypoplasia. The left vertebral artery is not affected as often. Signs of pathology are not observed immediately. Symptoms are closely related to hemodynamic disorders. This means that before a stagnation and insufficient supply of blood become clinically significant, a certain time must pass. It should be remembered that in the human body there are compensatory mechanisms that allow one to maintain normal nutrition during this or that period.
Causes of anomaly
Why does hypoplasia develop? The left vertebral artery may not form properly in the prenatal period for several reasons. The main ones are:
- Bruises, the fall of a woman in the process of bearing the fetus.
- The use of alcohol in the prenatal period, some medicines, drugs, as well as smoking.
- Infectious diseases transferred during pregnancy.
- Weighed down by heredity.
Against the background of hypoplasia, there is a significant narrowing of the lumen of the artery at the site of its entry into the canal leading to the cranial cavity.
Identification of pathology involves the use ofseveral methods of research. First of all, the expert in his conclusions is based on a clinical picture. In this case, we are talking about the information obtained during a neurologic examination, as well as about the patient's complaints. Diagnosis often reveals the tension of the occipital muscles, difficulty in turning the head, soreness when pressing on the processes of 1 and 2 vertebrae in the cervical region. The survey also uses radiography. An obligatory measure is an MRI. This procedure allows you to identify the exact cause of blood flow disorders, to detect the area of squeezing the vessel. One of the main diagnostic methods is UZDG (ultrasound dopplerography). During the diagnosis, the specialist should differentiate the syndrome with migraine.
If blood circulation is disturbed (narrowed orthe vertebral artery is deformed), treatment, as a rule, is complex. Therapeutic measures depend on the patient's age, the severity of the condition, and the individual characteristics of the patient. Due to the fact that such patients are at risk of stroke, the therapeutic measures are primarily aimed at eliminating blood supply disorders and spasms in the vessels. The complex uses vacuum treatment, pharmacopuncture. In addition, reflexotherapy is prescribed, and a number of medications are taken. Among the drugs shown for use are light antidepressants and anti-inflammatory drugs. Recommended medications such as "Aminophylline", "Cinnarizine", "Cavinton." When dizziness is appointed means "Betagistin."
In case of detection during the surveycirculatory disorders of the brain or spinal cord recommended hospitalization of the patient in a hospital. In the absence of an urgent need to stay in the hospital, a specialist can recommend a temporary wearing of the collar of Shantz. This corset is used to reduce the burden on the cervical spine. In the background of vertebral artery syndrome, manual therapy, physio-and acupuncture, electrophoresis with analgesics, phonophoresis, diadynamic currents are often prescribed.