Vertebrobasilar circulatory disorders
Vertebrobasilar circulatory disorders are conditions in which the blood supply to the back of the brain is disrupted.
Causes
In the neck, two vertebral arteries join to form the basilar artery, which enters the skull. These are the main blood vessels that provide blood flow to the back of the brain.
The areas in the back of the brain that receive blood from these arteries are needed to keep a person alive. These areas control breathing, heart rate, swallowing, vision, movement, and posture or balance. All of the nervous system signals that connect the brain to the rest of the body pass through the back of the brain.
Many different conditions may reduce or stop blood flow in the back part of the brain. The most common risk factors are smoking, high blood pressure, diabetes, and a high cholesterol level. These are similar to the risk factors for any stroke.
Risk factors for any stroke
A stroke occurs when blood flow to a part of the brain suddenly stops. A stroke is sometimes called a "brain attack or cerebrovascular accident. " I...
Read Article Now Book Mark ArticleOther causes include:
- Tear in the wall of an artery
- Blood clots in the heart that travel to the vertebral or basilar arteries and cause a stroke
- Blood vessel inflammation
- Connective tissue diseases
- Problems in the spinal bones of the neck
- Outside pressure on the vertebral or basilar arteries, such as from a salon sink (nicknamed beauty parlor syndrome)
Symptoms
Common symptoms may include:
- Difficulty pronouncing words, slurred speech
- Difficulty swallowing
- Double vision or vision loss
- Numbness or tingling, most often on the face or scalp
- Sudden falls (drop attacks)
- Vertigo (sensation of things spinning around)
- Memory loss
Other symptoms may include:
- Bladder or bowel control problems
- Difficulty walking (unsteady gait)
- Headache, neck ache
- Hearing loss
- Muscle weakness
- Nausea and vomiting
- Pain in one or more parts of the body, which gets worse with touch and cold temperatures
- Poor coordination
Poor coordination
Uncoordinated movement is due to a muscle control problem that causes an inability to coordinate movements. It leads to a jerky, unsteady, to-and-fr...
Read Article Now Book Mark Article - Sleepiness or sleep from which the person cannot be awakened
- Sudden, uncoordinated movements
- Sweating on the face, arms, or legs
Exams and Tests
You may have the following tests, depending on the cause:
- CT or MRI of the brain
MRI
A magnetic resonance imaging (MRI) scan is an imaging test that uses powerful magnets and radio waves to create pictures of the body. It does not us...
Read Article Now Book Mark Article - Computed tomography angiography (CTA), magnetic resonance angiography (MRA), or ultrasound to look at blood vessels in the brain
Ultrasound
Ultrasound uses high-frequency sound waves to make images of organs and structures inside the body.
Read Article Now Book Mark Article - Blood tests, including blood clotting studies
- Echocardiogram
Echocardiogram
An echocardiogram is a test that uses sound waves to create pictures of the heart. The picture and information it produces is more detailed than a s...
Read Article Now Book Mark Article - Electrocardiogram (ECG) and Holter monitor (24-hour ECG)
Electrocardiogram
An electrocardiogram (ECG) is a test that records the electrical activity of the heart.
Read Article Now Book Mark ArticleHolter monitor
A Holter monitor is a machine that continuously records the heart's rhythms. The monitor is worn for 24 to 48 hours during normal activity.
Read Article Now Book Mark Article - X-rays of the arteries (angiogram)
Angiogram
An arteriogram is an imaging test that uses x-rays and a special dye to see inside the arteries. It can be used to view arteries in the heart, brain...
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Treatment
Vertebral or basilar symptoms that start suddenly are a medical emergency that need to be treated right away. Treatment is similar to that for stroke.
Stroke
A stroke occurs when blood flow to a part of the brain stops. A stroke is sometimes called a "brain attack. " If blood flow is cut off for longer th...
Read Article Now Book Mark ArticleTo treat and prevent the condition, your health care provider may recommend:
Treat and prevent
A stroke occurs when the blood flow is cut off to any part of the brain. The loss of blood flow can be caused by a blood clot in an artery of the br...
Read Article Now Book Mark Article- Taking blood-thinning drugs, such as aspirin, warfarin (Coumadin), or clopidogrel (Plavix) to lower the risk for stroke
- Changing your diet
- Medicine to lower cholesterol and better control blood pressure
- Exercising
- Losing weight
- Stopping smoking
Invasive procedures or surgery to treat narrowed arteries in this part of the brain are not well studied or proven.
Outlook (Prognosis)
The outlook depends on:
- The amount of brain damage
- What body functions have been affected
- How quickly you get treatment
- How quickly you recover
Each person has a different recovery time and need for long-term care. Problems with moving, thinking, and talking often improve in the first weeks or months. Some people will keep improving for months or years.
Possible Complications
Complications of vertebrobasilar circulatory disorders are stroke and its complications. These include:
- Breathing (respiratory) failure (which may require the use of a machine to help the person breathe)
- Lung problems (especially lung infections)
- Heart attack
- Lack of fluids in the body (dehydration) and swallowing problems (sometimes requiring tube feeding)
- Problems with movement or sensation, including paralysis and numbness
- Formation of clots in the legs
- Vision loss
Complications caused by medicines or surgery may also occur.
When to Contact a Medical Professional
Call 911 or the local emergency number, or get to the emergency room if you have any symptoms of a vertebral or basilar circulatory disorder.
Reviewed By
Evelyn O. Berman, MD, Assistant Professor of Neurology and Pediatrics at University of Rochester, Rochester, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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Kernan WN, Ovbiagele B, Black HR, et al. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45(7):2160-2236. PMID: 24788967 pubmed.ncbi.nlm.nih.gov/24788967/.
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Liu X, Dai Q, Ye R, et al; BEST Trial Investigators. Endovascular treatment versus standard medical treatment for vertebrobasilar artery occlusion (BEST): an open-label, randomised controlled trial. Lancet Neurol. 2020;19(2):115-122. PMID: 31831388 pubmed.ncbi.nlm.nih.gov/31831388/.