Narrowing of the vertebral artery symptoms. Blockage in vertebral artery syndrome

Drug treatment brings relief only in 30-40% of cases. The positive effect of prescribing drugs is temporary. Complete cure possible only after surgery.

What is spinal stenosis

Signs of stenosis of the left vertebral artery canal begin to appear after internal cavity the vessel narrows by more than 50%.

Since the vertebral artery provides about 35-40% of the total blood supply to the brain, chronic failure occurs, evidenced by characteristic symptoms:

• Headaches - migraine crises are accompanied by dizziness and loss of vision clarity. The pain syndrome is not relieved with conventional analgesics.
• Lower back pain is one of the first symptoms of spinal vascular stenosis. The intensity increases while walking, physical activity. The pain does not go away when stopping or at rest. A decrease in pain is observed when the back is tilted forward.
• Numbness of the limbs. With the development of pathology and continued narrowing of the distal section, a syndrome is observed restless legs(pins and needles feeling) muscle weakness, tingling. Usually discomfort disappear when changing body position, especially when bending forward.
• Promotion blood pressure- occurs due to the body’s independent attempts to ensure normal blood supply to the brain. With prolonged hypertension, symptoms characteristic of arterial hypertension are observed: decreased visual acuity, impaired motor coordination, etc.

Appearance clinical manifestations indicates that pathological changes have become life-threatening for the patient.

There are three main causes of vertebral artery stenosis:

1. Congenital factor - genetic predisposition leads to congenital disorders in the structure of blood vessels. If the disease does not progress, people live with such stenosis full life, practically without restrictions.
2. The acquired factor is one of the main reasons why treatment of vertebral artery stenosis is required. Blockage of blood vessels can be caused by diabetes and metabolic disorders.
3. Traumatic factor. Narrowing of the artery occurs due to bruise, fracture, or hematoma at the site of injury. Must be assigned surgery in order to eliminate the causes of artery blockage.

How dangerous is the disease?

The progressive form of the disease is a criterion for disability. Regardless of whether it was carried out surgical treatment, a patient in the later stages of stenosis is placed on a disability group. Disability may be prescribed taking into account the consequences of stenosis (stroke, etc.)

Treatment methods for the disease and the consequences of stenosis largely depend on its location.

Before prescribing treatment methods, it is necessary to carry out differential diagnosis to determine the exact cause of the development of disorders, the degree of development and form of the disease. Classification of the degree of stenosis plays important role in determining the advisability of prescribing a surgical operation.

What methods are used to treat the disease?

Ultimately, the decision of what to treat depends on the patient himself. If the patient experiences constant dizziness, chronic lack of air, vasoconstriction over 70%, are absolute indications to perform a surgical operation.

What diet is optimal for treatment

You will need to exclude from the diet: fatty and high-calorie foods, sweets, flour. Instead, you should consume as much as possible more fish(any variety), fruits and vegetables. You should be careful when drinking alcohol, coffee and tea.

It has been observed that losing just a few kilograms of weight reduces the risk of rapid development of stenosis due to atherosclerosis. Physiotherapy is one of the best ways normalize the patient's weight.

Although in Lately Many developments have appeared aimed at overcoming stenosis, which is still the only method of combating a disease that has high efficiency, surgery remains.

Vertebral artery stenosis is a pathological disorder that can lead to coronary artery disease or stroke of the brain.

There is a certain complexity of treatment of this disease– in the early stages there are practically no symptoms.

Drug therapy brings relief only in 35-40% of cases.

And the positive effect of the prescribed drugs is temporary.

Complete cure is possible only after surgery.

Overview of Vertebral Artery Stenosis

The term stenosis refers to blocking, clogging and narrowing of blood vessels. Because of this, the circulatory system is disrupted. Also, the intensity of production of nutrients and oxygen in the brain is disrupted.

The first manifestations of stenosis can be noticed after the internal cavity of the vessel is reduced by more than 55%. This reduces brain nutrition by exactly half. As a result, the patient develops symptoms chronic failure, namely:

• sudden attack of headache;
• migraine crisis, which can cause dizziness;
• partial loss of vision;
• acute lumbar pain. This is the main manifestation of vertebral artery stenosis.
• numbness lower limbs. On skin You can constantly observe the so-called “goosebumps” on your legs. If you take a different position, they instantly go away.
• elevated blood pressure readings. In this way, the body tries to independently supply the brain with a full amount of blood.

Such manifestations can be a signal of serious pathological changes that threaten the patient’s life.

Causes of vertebral artery stenosis

There are three main causes of vertebral artery stenosis:

• Genetic predisposition. It can lead to congenital disorders of the vascular structure itself. If the disease does not progress, then they live a full normal life with it, without obvious restrictions.
• Acquired factor. The following pathologies provoke blockage of blood vessels: atherosclerosis, metabolic disorders and diabetes. For this reason, mandatory treatment of the vertebral artery is necessary.
• Traumatic factor. Narrowing of the vertebral artery artery can occur due to contusion, fracture, or hematoma formation at the site of injury. In this case, surgical treatment must be prescribed to eliminate the causes of artery blockage.

Types of stenosis and their complications

Unfortunately, doctors cannot give a favorable prognosis to patients diagnosed with vertebral artery stenosis. It all depends on where the violation occurred. If critical stenosis occurs in the right vertebral arteries, the patient suffers a stroke or death. The progressive form of stenosis can make the patient disabled.

The method of therapy and combating its consequences directly depend on the form of the disease and its location. Vertebral artery stenosis can be:

• subcompensated. The development of this form begins due to injury to the spine. There is no point in treating this form with medications, only surgery. They can also provoke a subcompensated form oncological processes. In this case, the disease ends in the death of the patient.
• estuarine As a result of this form of stenosis, the patient begins to experience serious emotional disturbances. Before surgery, the patient undergoes drug therapy.
• vertebrogenic. Characteristic signs this type of stenosis - painful sensations in the lower back and nearby sacral region. Typically, stenosis is not accompanied by inflammation. However, MRI shows the presence of moderate atrophy of the frontal lobe on the cerebral cortex.
• Compensated stenosis. The development of this variety is quite slow, with no signs of an acute form of the disease. There is no need for urgent surgical intervention.
• Intracranial stenosis. This type accompanied by arterial thrombosis. The pathology progresses rapidly and if the course is unfavorable, a stroke occurs.
• Stenosis of the left vertebral artery due to extravasal compression. Such stenosis develops due to abnormal diseases of the spine. Causes of development: osteochondrosis cervical region, hernias, oncological tumors and other pathologies. After all the causes of the disease have been eliminated, blood supply is restored.
• Stenosis of the right vertebral artery of extravasal compression - for this diagnosis, the etiology of development is identical to the narrowing that is observed in the left spine.
• Dynamic stenosis. Develops accompanied by partial or complete occlusion of blood vessels. It is the most dangerous for the patient’s life. Drug treatment can only eliminate symptoms, so it is used to prepare the patient for surgery.
• Functional stenosis. Symptoms occur only in certain neck positions. The disease develops against the background of such pathologies as spondylosis, osteochondrosis, and other diseases of the spinal structure.
• Decompensated stenosis is one of the most severe forms stenosis The narrowing of the left vertebral artery and lumen is chronic and becomes an irreversible process. Only decision is a complete replacement of a pathological section of an artery or artificial creation duplicate channel.
• Multifocal stenoses. This type represents multiple vascular lesions. Surgery is ineffective. Appointed drug treatment, if the goal is not achieved with its power, angioplasty is performed with the complete replacement of parts of the arteries that are damaged.
• Hemodynamically significant stenosis. At this state There is a narrowing of blood vessels by more than 50%. The result is a condition that affects normal blood flow as well as brain activity.

Before prescribing treatment methods, it is necessary to carry out differential diagnosis. It is carried out in order to determine the exact cause of the development of disorders, as well as the degree of development and form of the disease.

Classification of the degree of stenosis is considered particularly important in determining the appropriateness of surgery.

Treatment

Stenosis can be treated using three effective methods:

1. Medication. The patient is prescribed medications, which restore the functionality of blood vessels. They give them elasticity and strength. Doctors also prescribe medications to maintain blood pressure within normal values. Such drugs promote liquefaction blood clots and reduce the formation of blood clots. In addition to drug therapy, therapeutic exercises are prescribed, manual therapy and hirudotherapy (treatment with leeches).
2. Operational. Doctors are working to eliminate developing complications that arose as a result of injury using surgical correction. To treat stenosis of vegetative-vascular dystonia, doctors perform stenting. A metal frame is inserted into the affected area of ​​the vessel, which further prevents ruptures and narrowing of the vessels. Such stents can be located in human body no more than 15 years. Often, the frame is rejected. To avoid this, doctors cover it with plastic.
3. Folk. Many people resort to salvation folk medicine, but modern experts do not support this. Folk recipes can only be used in combination with traditional. Herbal Ingredients help normalize vascular tone and restore blood pressure.

Diet

There are some rules of nutrition for vertebral artery stenosis. This diet is aimed at overcoming the causes of narrowing of the arteries. There is no specific diet for stenosis. Patients are recommended to use any of the diets that are designed to combat diseases of the cardiovascular system.

It is necessary to exclude from the diet: sweets, flour, fatty and other high-calorie foods. Instead, you should eat more fruits and vegetables. Caution should be taken when taking alcoholic drinks, coffee and strong tea.

It has been observed that after losing a few kilograms of weight, the risk of stenosis formation decreases. Therapeutic exercises are one of the best ways to normalize a patient’s weight.

Despite the fact that many developments have recently appeared aimed at overcoming stenosis, at the moment the only method of combating the pathology that is highly effective is surgery.

According to various statistics, up to 30% of violations cerebral circulation associated with pathology of the vessels of the spinal zone, which form the spinovertebral circle at the base of the brain. And taking into account transient ischemic crises, they account for up to 70%.
It is the vertebral arteries that provide 1/3 of the required blood volume to the posterior lobe of the brain. The term “vertebral artery syndrome” combines any causes of compression that cause.

Treatment of vertebral artery syndrome is impossible without taking into account specific cause-and-effect relationships in the development of the disease. To decide whether to prescribe therapy, the doctor must be sure that vertebral artery stenosis can be compensated for by the chosen technique.

What reasons need to be dealt with?

A feature of the anatomy of the vertebral arteries is their varying degrees risk in the process of compression (narrowing). Before ascending to the cervical spine, the left artery arises directly from the aorta, and the right - from. Therefore, stenosis of atherosclerotic origin is more susceptible left-hand side. In addition, an anomaly in the structure of the first rib (additional cervical rib) often develops here.

One of the main influencing factors is a change in the bone structure of the canal formed by the transverse processes of the thoracic and cervical vertebrae. The patency of the canal is impaired when:

• degenerative-dystrophic changes associated with cervical osteochondrosis;
• intervertebral hernia;
• proliferation of osteophytes in spondylosis;
• inflammation of facet (joints between vertebrae) joints;
• vertebral injuries.

These causes are classified as vertebrogenic, associated with the spine. But there are also non-vertebral factors that should be taken into account in treatment. These include:

• atherosclerosis of one or both vertebral arteries;
• abnormal narrowing or tortuosity (congenital hypoplasia);
• increased influence of sympathetic innervation, causing spasmodic contractions vessel walls with a temporary decrease in blood flow.

Bone canals provide protection for brain nutrition

How does ICD-10 differentiate syndromes by cause?

In ICD-10, compression of the vertebral artery is taken into account along with the anterior spinal artery and is included in 2 classes of diseases:

• illnesses musculoskeletal system with code M47.0;
• defeats nervous system with code G99.2.

Accurate diagnosis, taking into account the development of anastomoses and anastomoses with other cervical arteries, allows you to choose treatment that is as close as possible to the source of the disease.

Main directions of treatment

Before vertebral artery syndrome is treated, the patient must undergo comprehensive examination for the purpose of diagnosing the type of vascular compression. The doctor receives essential information after:

• magnetic resonance imaging;
• angiography of vertebral and other cerebral vessels.

The methods allow you to accurately determine the degree of narrowing of the arteries. If normally the diameter should be from 3.6 to 3.9 mm, then with pathology its sharp decrease is detected. Localization of the narrow area is important for the likely surgical approach.

Symptoms of vertebral artery syndrome often occur suddenly, are accompanied by focal manifestations, and are very similar to an ischemic stroke. Therefore, it is necessary to diagnose and begin treatment in a specialized department.

Main treatment options:

• long-term use of medications that improve blood flow;
• course physiotherapy;
• taking advantage of opportunities physical therapy, a special set of exercises;
• surgical intervention according to indications.

Drug therapy

In the treatment of vertebral artery syndrome, a complex of drugs is used that affect the patency of the artery and extravasal pathology.

The most important medications are non-steroidal anti-inflammatory drugs. They cause anti-inflammatory, analgesic effects by inhibiting the migration of neutrophils to the site of inflammation, in addition, they reduce the ability of platelets to stick together and form blood clots. From the entire group, drugs are selected that are least toxic to the patient’s stomach and intestines. These include:

• Nimesulide,
• Meloxicam,
• Celecoxib,
• Aceclofenac (Aertal).

Aertal - new drug of this series, its toxicity is 2 times less than Diclofenac.

Muscle relaxants - centrally acting drugs are used, they relieve increased tone, muscle cramps, reduce pain. Applicable:

• Tolperisone,
• Baclofen,
• Mydocalm.

Of these drugs, Mydocalm has the greatest analgesic effect. By reducing muscle spasm, it simultaneously activates blood circulation.

At acute symptoms drugs are prescribed intramuscularly.

Vasodilators or vasoactive drugs such as Cavinton, Trental, Instenon can improve microcirculation in ischemic neurons of the brain. They act at the level of metabolic activation and provide energy to cells by accumulating ATP. At the same time, vascular tone and the ability of the brain to regulate its own blood circulation are restored.

Medicines to activate metabolism in brain cells:

• Glycine,
• Piracetam,
• Actovegin,
• Cerebrolysin,
• Semax.

They eliminate tissue hypoxia and have antioxidant properties. Treatment courses are carried out for 3 months twice a year. If necessary, synthetic antioxidants are prescribed: vitamins A, E, C, drugs Ionol, Phenosan.

Symptomatic remedies - according to indications, sedatives and antidepressants are used. For dizziness, Betaserc is prescribed. It is not recommended for long-term use.

Physiotherapeutic methods

In the acute phase of the disease, physiotherapy helps block pain impulses along the sympathetic nerve fibers. For this we use:

• diadynamic current for 5 minutes;
• ultrasound in pulsed mode;
• phonophoresis with solutions of Analgin, Anestezin;
• electrophoresis with ganglion blockers;
• d'Arsonval's currents on his head.

In the subacute stage, you can use electrophoresis with iodine, Novocaine, Euphyllin, Papaverine.

Physiotherapeutic techniques allow you to act on the deep layers of the neck and vertebral tissues

Reliable physiotherapeutic methods include: acupuncture, galvanization of the collar area. An individual mode of pulsed currents and ultrasound is also selected.

Manual therapy and massage can only be entrusted to a trained specialist.

Surgery

Surgery is prescribed for patients with ineffective conservative treatment and identified narrowing of the lumen of the vertebral artery to 2 mm or more.

In specialized departments of vertebrology and neurosurgery, surgical interventions are currently performed using endoscopic techniques. In this case, the skin incision is up to 2 cm, eliminating the risk of damage to vital important organs. The technique comes down to two options:

• excision of the site of narrowing and plasticity of the vessel;
• insertion of a balloon with a stent;
• in cases of detection of a tumor or hernia, the operation should eliminate the compressive effect on the arteries as much as possible.

Efficiency surgical method– up to 90%. In patients, symptoms of insufficient blood supply to the brain completely disappear.

If the narrowing of the vertebral artery is associated with osteochondrosis, then neurologists recommend wearing a Shants collar for 2.5 hours a day.

The orthopedic collar helps stretch the neck muscles, relieves tension and pain

For sleep will do only a semi-rigid mattress or a shield. You should purchase a pillow at an orthopedic supply store or make your own low, hard, flat cushion. It should prevent bending in the cervical spine.

To relieve pain, you can use wool scarves, rubbing with bee and snake venom.

A home remedy - a roller massager - is convenient to use while sitting in front of the TV.

As an antioxidant therapy, patients are recommended to include it in their diet. fresh berries, fruit juices, prunes, sea buckthorn, cranberries, currants, chokeberry, nuts, beans.

Physiotherapy

Special gymnastics is included in the mandatory prescriptions for vertebrogenic effects on the vertebral artery. Exercises can be performed both in the morning and several times during the working day. Can't force it physical activity with intense pain. The goal is to strengthen the muscular frame of the spine.

The areas of the hands have a reflex effect on the vessels of the neck. Therefore, the following light exercises are recommended:

• clenching your fingers into a fist and sharply spreading them out;
• circular movements in both directions in the wrist joint;
• finger massage.

To relieve heaviness and “pinching” in the neck area, any flexion and rotation movements of the arms are suitable:

• lifting and lowering;
• "mill";
• training biceps with light weight;
• “shrug” of the shoulders with lifting and lowering up and down.

While lying in bed, you can try to tense your muscles and rest the back of your head and heels on the surface of the bed. Or do this exercise while standing against a wall. While sitting, you can slowly tilt your head to the sides, back and forth.

If any symptoms of vertebral artery syndrome appear, you should undergo an examination. If it is possible to obtain good results from the use of medications, then the person lives and forgets about previously suffered ischemic manifestations.

Among the many existing pathologies, narrowing of the vertebral artery is distinguished by the fact that it can be congenital or acquired in nature. The term stenosis is commonly used for narrowing of the vertebral arteries. In addition to narrowing of blood vessels, this term can mean their blockage or partial blockage.

Such pathology of the vertebral artery may in the future cause ischemic disease and cerebral stroke. The ambiguity of therapeutic methods is complicated by the fact that early stages The disease is quite difficult to identify accompanying symptoms.

Reception medications is able to alleviate the patient’s condition only in 35-45% of cases. The improvement in condition is temporary and short-lived. Full recovery occurs only as a result of surgical intervention.

What kind of disease

Literally, as a result of disturbances, stenosis leads to difficulty in blood flow, and the overall intensity of supply of nutrients and oxygen to the brain flow decreases.

Signs of narrowing of the left vertebral arteries make themselves felt after the internal space of the vascular cup narrows by more than 50-55%.

Symptoms

Since the task of the vertebral arteries is to provide at least 35-45% of the total blood supply to the brain, narrowing of the lumen causes chronic failure.

A prolonged decrease in blood flow is indicated by the following symptoms:

• Periodic headaches - migraine crises occur mixed with dizziness, as well as a decrease in vision clarity.
• Pain in the lumbar region is one of the primary symptoms of spinal vascular stenosis. Exacerbation occurs during walking and during physical activity.
• Numbness of the limbs. With exacerbation of the pathology and progression of narrowing of the distal section, restless legs syndrome (a noticeable sensation of pins and needles), muscle weakness and tingling appears.
• Increased blood pressure - pressure increases due to the body’s spontaneous attempts to establish normal blood supply to the brain.

Main reasons

There are three main reasons for the development of vertebral artery stenosis:

1. Congenital factor - a predisposition at the genetic level leads to congenital changes in the structural structure of blood vessels. If the disease does not enter the acute phase, people with a similar diagnosis continue to live a full life.
2. Acquired factor - can be attributed to the main reason causing the need to treat narrowing of the vertebral artery. A blocked blood vessel condition can cause diabetes, atherosclerosis and various metabolic disorders.
3. Traumatic factor - the artery narrows due to force (fracture, bruise, hematoma). Surgery to eliminate the causes of the blockage is mandatory.

Danger of disease

It is worth judging the danger of a disease based on the location of the pathological changes. Acute stenosis of the right vertebral artery threatens with a stroke, and death is not excluded.

The progressive form of the disease is the main factor for confirming disability. Regardless of whether there was surgical intervention, a patient in the later stages of stenosis is assigned to the disability group.

Variety

Therapeutic options and possible consequences diseases largely depend on the site of its localization.

• Estuary stenosis - noticeable emotional disturbances are observed: panic attacks, pressing pain in the area of ​​the frontal lobe, photophobia, irritability. Focusing on character pathological disorders, the need is determined surgical intervention and possible drug therapy for the preoperative period is selected.
• Vertebrogenic stenosis - the main symptoms are pain syndrome in the lumbar or sacral region. This type of disease is not typical inflammatory process. MRI reveals moderate signs of atrophy of the frontal lobe of the cerebral cortex.
• Subcompensated stenosis - the main reason for its appearance is the action of a traumatic factor. Drug therapy will not bring results; it only requires surgical correction. Another reason may be the presence of cancer. With this diagnosis, the disease often leads to death.
• Intracranial stenosis occurs in conjunction with arterial thrombosis. In the presence of unfavorable factors, the disease quickly progresses and leads to stroke.
• Compensated stenosis - pathological condition the patient is hardly noticeable, acute form practically absent. The need for urgent surgery is not a priority.
• Stenosis of extravasal compression of the left vertebral artery - the disease arises as a result of abnormal conditions of the spine. The reasons include hernia, osteochondrosis of the cervical spine, oncology, etc. Having overcome the underlying disease, the blood supply, as a rule, returns to normal.
• Stenosis of extravasal compression of the right vertebral artery - similar diagnosis corresponds to the etiology of narrowing of the spine on the left, although it is localized on the right side.
• Multifocal stenoses - lesions of blood vessels in plural form. Surgery ineffective. Clear drug therapy is indicated, and if there is no effect, angioplasty is prescribed with complete replacement of the defective sections of the arteries.
• Dynamic stenosis - complete or partial occlusion is observed vascular wall. The condition is classified as extremely dangerous for the patient’s life. Drug therapy is aimed only at alleviating symptoms and serves mainly to prepare the patient for surgery.
• Hemodynamically significant stenosis is a pathology in which the vascular lumen is narrowed by more than 50%. The consequences negatively affect blood flow to the brain.
• Functional stenosis - symptoms appear only in certain postures of the cervical spine. Progression of the disease can occur in the presence of spondylosis, osteochondrosis and other pathologies of the spine.
• Decompensated stenosis - pathology takes up the most space severe conditions. The narrowing of the lumen of blood vessels becomes irreversible, chronic form. Only rational decision, complete replacement of a defective section of an artery or the formation of a backup channel.

Before choosing therapeutic methods, it is necessary to undergo differential diagnosis. This procedure will show a more accurate reason for the development of deviations, indicate the real phase and form of the disease. When determining the feasibility of surgical intervention, the main classifier is the degree of development of stenosis.

Treatment methods

Basically, one of three methods of combating the disease is used. In some cases it is possible joint use two methods of treating spinal vascular stenosis.

Drug therapy

The method is based on purpose and application vascular drugs, helping to maintain strength and elasticity. Also appointed medicines to control blood pressure, thin the blood and reduce blood clots. Along with medications, courses of physical therapy are prescribed, and manual therapy and hirudotherapy are also indicated.

Surgery

This procedure is aimed at surgical correction to eliminate traumatic complications and disorders in the structure of the spine. Stenosis can also be treated with stenting. A reinforced metal frame is placed in the artery, which prevents further rupture and narrowing of the vascular bed. Stents are designed for an average of 15 years of successful functioning. To reduce the risk of rejection, the steel frame is coated with special plastic.

Traditional methods of treatment

Such methods have not yet found recognition among representatives official medicine. But, according to the available data, medicinal decoctions and tinctures help normalize vascular tone, restore set blood circulation parameters and regulate blood pressure. As prophylactic, used in narrowing vascular systems vertebral arteries, folk remedies look quite effective.

To determine the optimal type of therapy, the appropriate specialist issues a referral for several diagnostic procedures. Duplex scanning of certain arteries is recognized as one of the most informative and reliable methods for obtaining a full-scale picture of pathological changes. As additional option An MRI of the area of ​​stenosis may be prescribed.

The final decision on treatment methods should be made by the attending physician together with the patient. If the patient complains of regular dizziness, chronic lack of air, general weakness and irritability, and vasoconstriction is determined to be at least 70%, then these signs are serious reason to perform a surgical operation.

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 dense plaques over time. 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. Large protrusions in the spinal area 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:

• Not proper nutrition(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).
• Vegetative symptoms in the form of sweating, chills, chilliness of the extremities, lability of 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 a short-term loss of consciousness as a result of sharp turns heads).

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 blockers calcium channels(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 is narrowed, then physiotherapy (reflexotherapy, ultraphonophoresis, magnetic therapy) is required. When narrowing blood vessels due to atherosclerosis, you should adhere to a diet (refuse fatty foods, sweets and bakery products).

Surgical

IN severe cases surgical correction is required. 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

Forecast at 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.