Vertebral artery stenosis. Vertebral artery syndrome with cervical osteochondrosis - symptoms. How to treat vertebral artery syndrome at home

Many brain ailments are explained by insufficiently proper functioning of blood vessels, for example, their atherosclerotic lesions and other violations. Therefore, the correction of such diseases is primarily aimed at determining the cause of their development and eliminating it. Scientists claim that proper blood circulation throughout the human body directly depends on the functioning of the Circle of Willis, located in the brain. It consists of a pair of branches of the vertebral arteries. The topic of our conversation today will be the narrowing of the left vertebral artery or right.

Stenosis, or in other words, narrowing of the vertebral artery causes severe brain symptoms, represented by severe pain in the left or right side of the head, loss of consciousness and convulsions. Therefore, in such a pathology, it plays an extremely important role. timely diagnosis and adequate therapy.

Narrowing of the artery in the spine can lead to irreversible changes in brain tissue, because it is through these vessels that blood and, accordingly, all nutrients enter the brain. Therefore, with this kind of stenosis, hypoxia of the supplied areas occurs. There is evidence that about a fifth of brain structures receive nutrition from the vertebral arteries (left and right), which pass from the left and from the right side through holes in the transverse processes of the cervical vertebrae.

Manifestations

Narrowing of the right or left vertebral artery can manifest itself in a number of different symptoms. They can be represented by dyspeptic symptoms (nausea and vomiting), pain syndrome of the cervical-occipital part and peripheral pain, which doctors also classify as a symptom of helmet removal. In some cases, stenosis of this kind makes itself felt by increasing unpleasant symptoms when sleeping on a pillow. The patient may be bothered painful sensations shooting and pulsating character that arise in response to external influences on the head, for example, when touched or when the wind blows.

Pain that occurs due to narrowing of the vertebral arteries is a strong character. When the left artery is narrowed, they are localized on the left side, and when the right artery is narrowed, respectively, on the right.

Quite often, the narrowing of such vessels is accompanied by the development of vestibular syndrome. Similar condition manifested by staggering, instability and severe attacks of dizziness.

Even if the disease occurs in an uncomplicated form, it can lead to a short-term loss of consciousness, for example, due to a sharp turn of the head, vibration or pressure on the neck. With such symptoms, the patient should not be administered vehicle.

Against the background of narrowing of the vertebral arteries, secondary pathologies may develop from inner ear or the brain. In this case, the clinical symptoms are also accompanied by tinnitus, a feeling of nausea and decreased hearing acuity.

Also stenosis vertebral vessels negatively affects visual acuity, causing a noticeable decrease in vision, frequent eye fatigue and pathologies visual analyzer.

Causes

The narrowing of the vertebral arteries in the vast majority of cases is the result of vascular atherosclerosis, in which cholesterol plaques are deposited on the walls of the arteries. Also similar pathology can be explained nervous spasm or external compression of the vertebrae. Sometimes it is caused by tumor formations and thromboembolism. In some cases, the cause of stenosis is tortuosity of either one vertebral artery, or even both.

Treatment methods

To correct narrowing of the vertebral arteries, conservative and surgical therapy. Drug treatment may include the use of drugs to treat atherosclerosis, such as statins. Also used are drugs that help normalize blood flow, medications to correct fainting and dizziness, eliminate nausea and muscle spasms. In some cases, it becomes necessary to use anti-inflammatory drugs. The drugs of choice are often those represented by Trental, Actovegin, Vinpocetine, Ceraxon, Cinnarizine, Cerebrolysin, Thiocetam, etc.

In some cases, an excellent effect can be achieved by non-drug therapy, namely massage or reflexology procedures. In addition, techniques can be used manual therapy. Gives wonderful results various procedures to improve blood flow and eliminate spasms, perform gymnastics and post-isomeric relaxation.

Sometimes, in order to increase the passage of the artery, the narrowing is corrected only operational methods. So, to restore full blood supply to the brain, doctors can perform endarterectomy - direct deletion formed atherosclerotic plaque from the affected vessel. For tortuosity of the vertebral artery and other pathologies, stenting or balloon angioplasty is also practiced. In this case, the affected vessel helps maintain the physiological lumen of the vessel or form it.

Correction of narrowing of the vertebral arteries is not always successful, especially if the disease has gone too far and led to the development of irreversible changes in the brain.

Stenosis (narrowing) of the vertebral artery (left or right) leads to severe brain symptoms: strong pain in the left and right half of the head, loss of consciousness, convulsions. For right stenosis pain syndrome is localized on the right, when left - on the opposite side.

At early diagnosis vertebral compression, proper treatment Irreversible changes in brain tissue are prevented. Through this vessel blood flows to the brain tissue. About 20% of the structures are fed by blood supply from the vertebral arteries on the right and left, passing through the openings of the transverse processes of the vertebrae of the neck.

MRI cervical spine spine in a patient with vertebrobasilar insufficiency

X-ray with narrowing of the lumen of the vertebral artery: right or left

Traditional radiography does not show narrowing of the lumen of the vertebral arteries (right or left) pathological manifestations. Neurologists send patients with certain clinical symptoms:

1. Dyspeptic phenomena(vomiting, nausea);
2. Pain syndrome of the cervical-occipital part;
3. Peripheral tenderness (helmet removal symptom);
4. Strengthening the clinic when sleeping on a pillow;
5. Shooting, throbbing pain when externally applied to the head (touch, wind).

In patients with vertebral artery stenosis, neurologists often see vestibular syndrome, in which staggering, instability, and severe attacks of dizziness are observed.

Even with an uncomplicated course, a short-term loss of consciousness is possible with a sharp turn of the head, vibration, or pressure on the neck. A person with such clinical symptoms should not drive a car.

Noise, nausea, hearing loss affect everyday life as a manifestation of a number of secondary pathology from the inner ear, brain.

Traditional radiography of the cervical spine visualizes narrowing of the intervertebral discs during a degenerative-dystrophic process, prolapse, or hernia.

The task of an x-ray in the presence of a drop attack (sudden fall) is to establish the likelihood of a violation of the blood supply in the vertebrobasilar system, to identify possible displacement of the vertebrae, instability, and scoliosis. For these purposes, functional images are taken with maximum flexion and neck extension. X-rays help assess the degree of cervical flexion and exclude or confirm vertebral instability.

MR angiography of the vertebral arteries with stenosis. When prescribing radiography, a radiologist identifies the proliferation of marginal osteophytes in the area of the semilunar joints. The changes are clearly visualized in the direct image. Osteophytes are localized along the upper edge of the contours of the anterior part of the vertebral bodies.

Lateral radiographs of the cervical spine examine the condition of the cervical vertebrae, intervertebral spaces, and hyperlordosis (excessive convexity of the natural curvature).

With any of these disorders, decreased vision, eye fatigue, and pathology of the visual analyzer are observed. With late therapy, it is impossible to prevent the irreversible development of visual impairment using either conservative or surgical methods. X-rays of the cervical spine do not show shadows of the vessel. To study the state of blood supply, contrast angiography, magnetic resonance imaging, and Doppler sonography are required.

Methods radiology diagnostics We will consider stenosis of the right or left vertebral artery below.

Why does narrowing of the vertebral artery develop?

Impaired blood supply to the brain depends on the degree of compression of the vertebral artery. The narrowing is caused by atherosclerosis, nerve spasm, external compression of the vertebrae, tumor, thromboembolism.

The cause of impaired blood supply to the vertebrobasilar area may be tortuosity of one or both vertebral arteries. To treat the pathology, stenting and balloon angioplasty are used.

Procedures are performed under local anesthesia. The stent is installed through a puncture femoral area. The introduction of an endoprosthesis is necessary to maintain the physiological lumen of the vessel. Until a few years ago, stenting was performed under X-ray control. A scopic cover was used to visualize the insertion of the balloon stent. The movement of the balloon from the femoral to the vertebral artery is clearly visible on the X-ray television screen. The procedure resulted in radiation exposure to the patient, so modern stage control of the intervention is carried out under the guise of ultrasound.

Narrowing of the left vertebral artery: symptoms

Narrowing of the left vertebral artery can be suspected if the following symptoms are present:

1. Headache syndrome is characterized by dull, burning pain with localization in the parietal occipital region. The symptom intensifies with severe physical activity. The probable location of pain is the superciliary, temporal, parietal areas;
2. Symptoms from the outside gastrointestinal tract. Nausea and vomiting occur in many patients with vertebrobasilar insufficiency. Fight them medicines impossible. Mechanism dyspeptic disorders– compression of the vertebral artery with impaired blood supply to the intestines;
3. Disturbances in the functioning of the central nervous system– memory loss, changes in visual acuity, eye pain;
4. Vestibular disorders – disorientation, tinnitus;
5. Changing the frequency of contractions of cardio-vascular system, pressure instability, angina attacks.

In addition to surgical and conservative treatment, patients with vertebrobasilar insufficiency need to undergo an additional complex medical procedures– physiotherapy, massage, kinesiotherapy (treatment with physical movements).

Narrowing of both vertebral arteries is dangerous pathology, in which serious complications develop.

X-ray of the cervical spine in a lateral projection with a decrease in the height of the vertebral bodies at the lower level

Difficulties are caused by timely diagnosis of nosology. To identify the disease, not only x-rays are used, but also other radiation diagnostic methods.

Principles of treatment of vertebral artery syndrome

When both vertebral arteries are narrowed, treatment is aimed at eliminating the main pathogenetic links of the process:

1. Elimination of neurogenic spasm;
2. Improving microcirculation of the vertebrobasilar area;
3. Vertebrogenic effect on the tone of the vascular wall.

Complex treatment necessarily includes agents that reduce blood viscosity and dilate blood vessels - dipyridamole, pentoxifylline, vinpocetine.

X-rays with narrowing of the right or left vertebral artery are not used to diagnose the disease, but to identify possible reason compression of the vertebral vessel in the neck.

Methods for detecting compression of vertebral vessels (right and left)

Methods for diagnosing stenosis of vertebral vessels on both sides:

1. Magnetic resonance imaging allows you to determine anomalies in the structure of the bone bed in which the vessels run;
2. X-ray of the cervical spine - to identify vertebral instability, displacement, neck hernia, and other anatomical structures that interfere with blood flow in the vertebrobasilar region;
3. Dopplerography helps evaluate blood flow deviations from normal values. The more the circulation is reduced, the more likely severe complications in the brain;
4. Duplex scanning– prescribed to identify lesions localized on the inner wall of the vessel;
5. Angiography cervical vessels– examination after contrast injection into the vessel. CT or MRI may be used for imaging, as the methods allow for the creation of a three-dimensional simulation of the condition of the neck.

To determine the level of blood supply disturbance in the area of the base of the brain, a ultrasound scanning with Dopplerography. The procedure is used not only to identify blood supply disorders, but also for the purpose of dynamic monitoring of the nature of microcirculation during treatment with vasodilator drugs.

Neuroimaging through magnetic resonance imaging can be used to identify changes in the brain that lead to similar symptoms.

MRI angiography is considered a fairly promising method that shows the condition of the transcranial and brachiocephalic arteries. The study allows for a thorough examination of the character cerebral blood supply, identify blood clots, vertebral artery stenosis. Magnetic tomography reveals atherosclerotic plaques, determine the features of angiography.

X-ray of the cervical spine is used in conjunction with MRI to additional diagnostics. To obtain maximum information, it is recommended to perform functional tests at maximum extension and flexion.

Vertebral artery stenosis – dangerous disease, which consists in narrowing the lumen of a blood vessel. The vertebral artery is responsible for transporting blood to the human brain, and therefore vertebral artery stenosis is fraught with the development of ischemic stroke.

What it is

Through carotid arteries About 70-75% of the blood entering the human head passes through. If the blood flow in one of the veins is disrupted, then, accordingly, the overall blood supply to the head deteriorates. Even if there is no complete blockage of the artery, but only a circulatory disorder, the patient will definitely feel a deterioration in health: loss of vision and hearing, dizziness, and general weakness.

Spinal artery stenosis is a narrowing or complete blockage of a vessel that disrupts the normal blood supply to the brain and its nutrition. As a result, hypoxia develops, that is, oxygen starvation head organs. As a rule, symptoms of stenosis begin to develop if the lumen of the vessel narrows by half.

Stenosis of the right vertebral artery, stenosis of the left vertebral artery, or stenosis of both may develop. blood vessels. If the disease develops, it can lead to disability and even fatal outcome. In order to prevent such sad consequences, it is necessary to try to start appropriate treatment as quickly as possible.

Symptoms

Regardless of whether vertebral artery stenosis is observed on the left or right, the symptoms are the same:

severe attacks of headache that cannot be relieved with conventional painkillers. In this case, migraine often has a paroxysmal character, accompanied by a drop in visual acuity and severe dizziness;
lower back pain that gets worse during physical activity. In this case, the discomfort does not disappear even in a sitting or lying position. You can ease the sensation a little by leaning forward;
feeling of cold, numbness in the extremities, crawling on the skin, weakness in the muscles. As a rule, after a short warm-up discomfort disappear;
development of hypertension. To ensure normal blood flow, the body begins to increase blood pressure. As a result, the patient may develop hypertension.

If a patient experiences these symptoms, this means that the disease is progressing, and therefore appropriate measures should be taken immediately.

Reasons for appearance

Doctors call following reasons development of vertebral artery stenosis:

congenital factor, that is hereditary predisposition To vascular diseases. In some patients, the disease practically does not progress and does not interfere with full life person;
acquired reasons: diabetes, metabolic disorders, atherosclerosis. As a rule, such reasons appear with age, most often in people over 40 years of age;
injuries. Often the cause of a decrease in the lumen of the artery is injury to the vessel. It may not even be a full-fledged wound, but a banal bruise, when a hematoma occurs at the site of the impact. In case of poor regenerative ability, the lumen may narrow down to the point of complete blockage of the vessel.

Diagnostic issues

To diagnose the problem, you should comprehensive examination. First, the doctor interviews the patient, finding out what exactly he is complaining about. Special attention You need to pay attention to the issue of dizziness, headaches and the like.

The first diagnostic method is Doppler ultrasound. This method The examination allows you to study the condition of the blood vessels in the brain, identifying disturbances in their functioning.

X-rays can be used to check blood flow to determine the presence of atherosclerotic plaques. When deciding on the advisability of surgical intervention, it is necessary to perform contrast panangiography.

In case of exacerbation, it makes sense to conduct magnetic resonance imaging, which will determine the quality and speed of blood flow, and also allow us to study the condition of each layer of the walls of the vertebral artery. CT scan carried out with an introduction to circulatory system contrast agent and allows you to accurately determine the location and degree of narrowing of the blood vessel.

Since insufficient examination has repeatedly turned out to be the reason for the diagnosis misdiagnosis, then it is necessary to carry out the maximum diagnostic procedures. If the doctor doubts the diagnosis ( similar symptoms has a whole range various diseases), then it makes sense to undergo a re-examination at another medical institution.

The treatment method depends on the degree of neglect and speed of development of the disease.

First of all, the doctor should recommend conservative treatment. The first step should be to completely eliminate the factors that contribute to the growth of atherosclerotic plaques. For this purpose, statins are prescribed - drugs aimed at combating cholesterol in the patient’s body. To restore blood flow speed, smoking should be completely eliminated.

To avoid blood clots, it is necessary to use antiplatelet therapy. The most inexpensive and at the same time in an effective way is the reception acetylsalicylic acid(Aspirin). The drugs should be used throughout life.

In advanced cases it will be necessary surgical intervention. The following methods are considered the most effective:

endarterectomy - removal of part of the artery wall affected by atherosclerotic plaques. A normal vessel has smooth walls, but if atherosclerosis develops, growths form on them, preventing normal blood flow. In some cases, the lumen is completely blocked by atherosclerotic plaques. The endarterectomy technique involves the surgeon making an incision in the artery at the site of the lesion. Through this incision, special instruments are used to clean the artery from plaques. The operation allows you to return the lumen to normal sizes and restore normal blood flow;
endovascular artery repair with stent implantation. In this case, the doctor inserts a special stent into the vein through a catheter, which expands the vessel and restores blood flow. Endovascular arteryplasty is used when stenosis develops in hard-to-reach places, after radiation therapy and in some other cases.

Traditional methods

Traditional medicine on this moment can't really offer effective technique. All kinds of decoctions and tinctures can strengthen the walls of blood vessels and improve blood flow, but the problem will not be completely solved.

Can stop the progression of the disease proper nutrition. To do this, you need to exclude fatty and fried foods and introduce sea fish, rich healthy fats. Eat as many vegetables and fruits as possible, try to limit tea, coffee, and packaged juices.

Allows you to get rid of many weight loss problems. Be sure to do morning exercises, and do not neglect visiting the gym.

Vertebral artery stenosis is a pathology in which the lumen of blood vessels decreases and blood flow is disrupted. Each person has 2 vertebral arteries. They supply blood to the brain. This pathology, in the absence of proper treatment, leads to the development of vertebral artery syndrome and.

Reasons for development

The causes of narrowing of the vertebral arteries are:

Atherosclerosis. With it, atherogenic lipoproteins (VLDL and LDL) are deposited on the endothelium of the vertebral arteries, forming over time dense plaques. They clog blood vessels, impairing blood supply to the brain.
Violation of fat (lipid) metabolism.
Structural anomalies of Kimerli and Klippel-Feil, basilar impression.
A sharp spasm of the muscles located next to the vertebral arteries (inferior oblique, scalene). Leads to compression of blood vessels.
Neoplasms (tumors, cysts).
Intervertebral hernia. Protrusions in the spine large sizes lead to compression of blood vessels and disruption of blood flow. Most often, stenosis is caused by hernias in the cervical region.
Cervical osteochondrosis. With this pathology, bone spines are formed that can compress surrounding tissues.
Degenerative-destructive changes in the cervical spine (spondyloarthrosis).
Congenital anomalies of vascular development.
Systemic vascular diseases (vasculitis).
Thromboembolism. Promotes narrowing of the artery by a detached blood clot.
Thrombosis.
Hypoplasia of the vascular wall.

Predisposing factors for the development of stenosis are:

unhealthy diet (excessive consumption of animal fats and simple carbohydrates);
smoking;
high pressure;
diabetes;
violation of metabolic processes;
systemic diseases;
elderly age;
tendency to thrombosis;
increased blood clotting;
sedentary work and improper organization of the workplace (contribute to spinal diseases).

Symptoms and diagnosis

Signs of vasoconstriction are:

Periodic headache. With vascular stenosis, basilar migraine often occurs. It is characterized by a severe, throbbing headache predominantly in the occipital region. Headache worsens after sleep, during shaking and when turning.
Noise in ears.
Dizziness.
Vestibular ataxia (deterioration of coordination of movements, unsteadiness when walking, sleep disturbance, nausea, vomiting).
Autonomic symptoms in the form of sweating, chills, chilliness of the extremities, lability blood pressure, rapid heartbeat, redness of the face and pallor of the skin.
Visual impairment (decreased visual acuity, nystagmus, fog, rainbow circles and stripes before the eyes, fast fatiguability during visual work).
Pain in the neck area. Most often it is felt from behind and radiates to the frontal and parietal lobes.

If transient ischemic attacks develop against the background of arterial stenosis, motor, speech and sensory disorders appear, visual disturbances in the form of hemianopsia (loss of visual fields), diplopia (double vision) and dysphagia.

When the left or right vertebral artery is narrowed, drop attacks (characterized by episodic weakness in the limbs and tilting of the head) and Unterharnscheidt syndrome (manifested by short-term loss consciousness as a result of sudden turns of the head).

To make a diagnosis you will need:

taking anamnesis;
physical examination;
assessment of neurological status;
neurological examination;
radiography of the spine in 2 projections;
CT scan;
Magnetic resonance imaging;
rheoencephalography (assessment of blood filling of the arteries in the head and neck area);
Doppler ultrasound;
angiography;
duplex scanning;
ophthalmological examination;
functional tests;
general clinical tests;
lipidogram.

The doctor’s task is to determine the causes of stenosis (narrowing) of the left or right vertebral artery.

Treatment

Treatment can be outpatient or inpatient. The treatment regimen is determined by the underlying disease (the cause of vasoconstriction). If there is narrowing of the vertebral artery on the right or left, then complex therapy. It includes:

Use of systemic drugs.
Massage of the collar area.
Gymnastics (physical therapy).
Proper nutrition.
Manual therapy.
Wearing a Shants collar.
Physiotherapy.
Application folk remedies (herbal infusions, decoctions).
Surgical intervention.

Medication

cure this pathology The following medications allow:

Statins (Aterostat, Symvor). Indispensable for arterial stenosis due to atherosclerosis.
Selective calcium channel blockers (Nimodipine, Nimopin, Nimotop). They are shown when neurological symptoms against the background of cerebral ischemia.
Antiplatelet agents, anticoagulants and thrombolytics (Clopidogrel, Aspirin, Thrombo Ass, Heparin, Streptokinase). Prescribed for thrombosis.
NSAIDs.
Muscle relaxants.
Chondroprotectors (prescribed for osteochondrosis). Arthra, Dona, Chondroguard and Teraflex are used.
Eufillin.
Metabolic agents (Meldonium, Mildronate, Mildroxin).
Neuroprotectors (Cinnarizine, Pentoxifylline, Nootropil, Lucetam, Piracetam, Trimetazidine, Cavinton, Vinpocetine, Mexidol, Picamilon, Pikogam, Cerebrolysin, Glycine).

Non-drug

If the right or left artery, then physiotherapy is required (reflexotherapy, ultraphonophoresis, magnetic therapy). When narrowing blood vessels due to atherosclerosis, you should adhere to a diet (refuse fatty foods, sweets and bakery products).

Surgical

IN severe cases required surgical correction. Can be carried out:

Decompression (reducing intracranial pressure). Required for the development of ischemic stroke.
Endarterectomy (resection of the affected artery).
Reconstructive operations.
Removal bone growths(osteophytes).
Vertebral stabilization.
Removal of the tumor.
Stenting.
Installation of implants in the spine.

Prevention

Measures to prevent stenosis of the vessels supplying the brain are: quitting smoking, treating atherosclerosis, proper nutrition, exercise, preventing spinal diseases and thrombosis.

Forecast and possible consequences

The prognosis with timely treatment and minor arterial stenosis is favorable. In advanced cases, the following complications are possible:

ischemic stroke;
transient ischemic attacks;
speech, hearing and vision impairment;
paresis and paralysis;
dementia;
migraine;
disruption of cerebral blood supply.

With systemic atherosclerosis, the prognosis worsens.

Stenosis of the vertebral artery is its narrowing, as a result of which blood circulation in the brain is disrupted, and a deficiency occurs nutrients, oxygen starvation nerve cells(neurons) and ischemic stroke. Vertebral arteries (VA) are one of the main vessels passing on both sides of the spine (left and right artery) and supply the brain with blood (up to 25% of the total volume of blood entering the head).

The essence of pathology

Chronic insufficiency occurs when there is a shortage of 35-40% of blood and is characterized by the following symptoms:

dizziness, migraines that are not affected by analgesics;
deterioration of vision - phenomena of floaters, dark spots or visual images before the eyes;
deterioration of memory and intellectual abilities;
impaired coordination of movements due to damage to the cerebellum;
lumbar pain, aggravated by walking and physical exercise subsiding when bending forward;
a feeling of numbness in the limbs, tingling and “pins and needles” in the legs, weakness in the muscles;
arterial hypertension;
pain in the cervical-occipital region.

If the vertebral artery is narrowed by half, then the patient’s condition worsens, sudden attacks loss of consciousness and circulatory failure, during which some brain cells die.

Reasons for the development of stenosis

According to the factors that provoked the development of stenosis, 3 main groups are classified:

Hereditary pathologies associated with blood vessels. In the absence of exacerbation, the disease does not manifest itself and the person remains active throughout his life.
Stenosis acquired as a result of diseases affecting blood circulation (atherosclerosis, diabetes and metabolic disorders).
Narrowing of arterial walls due to injury (bruise, fracture, hematoma).

Reasons for the development of stenosis:

diseases causing degeneration and dystrophy spinal columns cervical spine (osteochondrosis, spondylosis, ankylosing spondylitis), leading to confusion of the vertebrae and disruption of brain microcirculation;
atherosclerosis of blood vessels due to concentration cholesterol plaques in the cavity of blood vessels;
tumors of the vertebral processes;
bone growths (osteophytes) in the joints of the intervertebral space;
hypertonicity and spasms of the cervical and scalene muscles.

Depending on the affected areas, the following types of VA stenosis are distinguished:

Estuary stenosis is a form of damage to the vertebral arteries on the right or left, accompanied by mental disorders, which manifest themselves in outbreaks panic attacks, fear of death, compression pain in the frontal region, irritability and fear of light. The main treatment is surgical.
Subcompensated stenosis is provoked by injuries and resulting displacements in the cervical spine. Surgery is necessary to correct post-traumatic complications. If the lesion is caused oncological tumor, then such a disease ends in death.
Vertebrogenic stenosis - characterized by pain in the lumbar and sacral areas spine without any processes of inflammation and moderate changes in the frontal lobe of the brain cortex. The vertebral vessel is examined using MRI. Treatment is surgical through stenting through a puncture of the femoral artery and installation of an endoprosthesis.
Compensated stenosis is characterized by a slow course of the disease, when the lumen of the vessel walls gradually narrows and makes it possible to treat the disease with medication, without surgery.
Intracranial stenosis causes arterial thrombosis, progresses rapidly and provokes a stroke.
Narrowing of the left vertebral artery is a consequence of abnormal changes in the spine (cervical osteochondrosis, intervertebral hernia, cancerous tumors). The prognosis when the sources of disease development are completely eliminated is favorable, the blood supply to the brain tissue is restored.
Right vertebral artery stenosis—symptoms and treatment are similar to stenosis on the left side of the spine.
Dynamic narrowing of the VA - is expressed in complete or partial disruption of the patency of the arteries and is considered the most dangerous looking stenosis Treatment with drugs is only symptomatic; emergency surgical care is required.
Functional stenosis - manifests itself only in a certain position of the neck, progresses due to existing osteochondrosis, spondylosis and other lesions of the spine.
Multifocal stenoses are lesions of several or many vessels. Apply only drug therapy or angioplasty, which involves replacing diseased tissue in the arteries.
Hemodynamic means that the obstruction affected more than half of the vessel, which disrupts the functioning of the brain.
Decompensated stenosis - the disease becomes chronic, the process becomes irreversible. The prognosis is relatively favorable with complete replacement of the narrowed area arterial vessel or creating an alternative blood flow channel.
Stenosis spinal canal due to its narrowing. This type of stenosis is observed in lumbar region and causes compression of the nerve roots of the lumbar plexus and neuralgia sciatic nerve. Can also be observed in the cervical region spinal cord, squeezing the latter, which can lead to complete paralysis.

Diagnosis of insufficiency of cerebral blood supply

To study the blood circulation of the brain, the following instrumental methods are used:

Dopplerogram of the vessels of the cervical spine to identify processes of narrowing of the arteries;
angiography - introduction into blood vessels contrast agents and their radiograph to exclude atherosclerotic and anatomical disorders of the vascular system;
magnetic resonance angiography - scanning of contrast arteries;
CT using a contrast solution injected into the artery to determine the degree of stenosis;
Contrast panangiography is an X-ray using contrast agents to identify the presence and location of a blood clot for surgery.

Treatment of the disease

Narrowing of the vertebral artery is a disease in which it is necessary timely treatment, V otherwise complications can lead to ischemic stroke. Treatment of stenosis is prescribed based on the reasons that caused pathological processes, and type of stenosis.

Drug therapy involves influencing the signs of the disease, suppressing their manifestation: drugs that lower blood pressure are used (Indap, Lozap, Dibazol, etc.); orthopedic collars that limit the mobility of the cervical vertebrae; anticoagulants; means for normalizing blood circulation (Cinnarizine, Mildronate, Encephabol, Vasobral, Instenon, etc.); NSAIDs. However drug treatment effective only in 30-40% of cases, and there is a danger of regression of the disease.

In such situations, the use of radical methods is required.

Surgical intervention involves various types of operations depending on the course and localization of the process of narrowing of the vascular walls. Among them:

Endarterectomy - resection of damaged sections of the artery and insertion of an implant (stent).
Reconstructive operations - arteriolysis, resection and redressing of damaged sections of the VA.
Stabilization of the movement of the moving part of the spine.
Removal of osteophytes - bone growths in intervertebral joints.
Stenting is the insertion of a metal frame lined with plastic into the artery canal, which protects the vessel walls from narrowing.
Fixation of the cervical spine when removing some articular elements by installing special titanium systems.

Prognosis of VA stenosis

The prognosis of the disease in the vast majority of cases is quite unfavorable; the outcome is influenced by the location of degenerative changes in the VA. Critical stenosis of the right VA, as a rule, ends in a stroke with possible fatal. Patients who have suffered this illness are assigned a disability.

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