Stenosis vertebral artery – 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

About 70-75% of the blood entering the human head passes through the carotid arteries. 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 of the 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 death. 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:

1. congenital factor, that is, a hereditary predisposition to vascular diseases. In some patients, the disease practically does not progress and does not interfere with full life person;
2. acquired reasons: diabetes, metabolic disorders, atherosclerosis. As a rule, such reasons appear with age, most often in people over 40 years of age;
3. 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. Particular attention should be paid 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 whether to carry out 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 been the cause of an incorrect diagnosis, it is necessary to carry out a maximum of diagnostic procedures. If the doctor doubts the diagnosis ( similar symptoms It has whole line 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, surgical intervention is required. The following methods are considered the most effective:

1. 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 size and restore normal blood flow;
2. 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 currently cannot 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.

Proper nutrition can stop the development of the disease. 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 pathological disorder that can lead to coronary disease or cerebral stroke.

There is a certain difficulty in treating 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 surgical intervention.

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 internal cavity vessel is reduced by more than 55%. This reduces brain nutrition by exactly half. As a result of this, the patient develops signs of 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. You can constantly see so-called “goosebumps” on the skin of your legs. If you take a different position, they instantly go away.
• increased performance blood pressure. 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, be sure to prescribe surgery in order 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 of this type of stenosis are pain 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 acute form diseases. 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 that 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 gymnastics, manual therapy and hirudotherapy (leech treatment) are prescribed.
2. Operational. Doctors are working to eliminate developing complications that arose as a result of injury with the help of 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. Physiotherapy- this is one of the best ways bring the patient's weight back to normal.

Despite the fact that in Lately Many developments have appeared aimed at overcoming stenosis; at the moment, the only method of combating pathology that has high efficiency- This is a surgical operation.

Diseases of the cervical spine have now become widespread not only among elderly and middle-aged people, but also among young people. At the same time, the number of vertebrogenic vascular disorders brain, which became actual problem modern medicine. AND important role V similar situation plays stenosis of the vertebral artery.

General information

The blood supply to the brain comes from two main basins: carotid and vertebral (carotid and vertebral arteries, respectively). The latter covers a quarter of the total need for oxygen and nutrients - it vascularizes the following structures:

• Brain stem.
• Cerebellum.
• Occipital lobes.
• Extensive part temporal lobes.
• Posterior part of the hypothalamus.
• Spinal cord (segments C1–Th3).
• Inner ear.

Damage to the vertebral artery in diseases of the cervical spine is determined by its anatomical and topographical features. The vessel, together with the nerve of the same name, passes through the canal, which is formed by openings in the transverse processes of the vertebrae. The latter is not static, since it changes according to movements in the neck. In the vertebral artery itself, according to its location, several segments are distinguished:

• 1 – from the subclavian artery to the entrance to the canal.
• 2 – in the canal at the level of C2–C6 vertebrae.
• 3 – from the exit from the canal to the entrance to the cranial cavity.
• 4 – in the cranial cavity (intracranial).

In the canal, the artery borders posteriorly with the uncovertebral joints, and laterally with the superior articular processes. After leaving it, the vessel bends twice: in the frontal and sagittal planes. It is in these places that disruption of blood flow through the vertebral artery often occurs.

The topographic and anatomical features of the vertebral artery make it vulnerable to the adverse effects of a number of external and internal factors that contribute to impaired blood flow through the vessel.

Causes

The narrowing of the lumen of any vessel is provoked by several reasons. Possible compression of the wall from the outside pathological formations(bone fragments, tumor, hematoma, etc.), internal blockage with an atherosclerotic plaque, thrombus, embolus, and, finally, spasm of the muscularis propria (most often reflex). In relation to the vertebral artery, it is customary to distinguish two main groups of factors:

• Vertebrogenic.
• Nonvertebrogenic.

The former cause external compression vascular wall and the adjacent nerve due to pathological changes in the cervical spine. In this case, the compressive elements are:

• Bone growths(osteophytes).
• Disc herniation.
• Osteoarthrosis (of the facet joints).
• Instability of spinal segments.

Structural disorders in the spine affect not only the artery itself, but also nerve fibers, entwining it, leading to a reflex spasm. The factors of external compression can easily include the muscles of the neck - hypertrophied or spasmed (anterior scalene, inferior oblique) - which often accompanies pathology of the spinal column.

It should be noted that even in physiological conditions The vertebral artery is subject to changes in its lumen when moving the head, but normally the restriction of blood flow is well compensated. And if, along with external compression, there are changes in the vessel itself, then the situation is aggravated many times over, manifesting itself as clear hemodynamic disturbances in the vertebrobasilar region. Factors unrelated to the condition of the spine include:

• Internal occlusion with thrombosis, atherosclerosis, arteritis, embolism.
• Vascular deformations: pathological tortuosity, additional loops, kinks, course anomalies.
• External compression by scars, adhesions, hematomas and other space-occupying formations.

Thus, the causes of stenosis cover a wide range of pathologies - both local and systemic. Therefore, in the practice of a neurologist, vertebrologist and traumatologist, great importance is given to differential diagnosis vertebral artery syndrome.

Narrowing of the vertebral artery in most cases is caused by pathology of the cervical spine, but there are also non-vertebral causes of stenosis.

Symptoms

Based on the functional load on the vertebral artery, it is easy to predict what manifestations of stenosis may occur. Disruption of blood flow through the vessel due to the failure of compensatory mechanisms provokes hypoxic changes on the part of those structures that feed from the vertebral part of the brain basin. Of course, everything depends on the severity of pathological changes, but it should be mentioned that hemodynamically significant stenosis corresponds to blocking of the vascular lumen by 50% or more. Accordingly, the stronger the external compression or internal occlusion, the more significant the clinical picture.

The complex of neurological disorders that occur with stenosis is combined into the concept. In the early stages, it has a functional nature, that is, it occurs only at the moment of provoking movements - a sharp tilt or turn of the head - as well as in the case of a prolonged forced position. In this case, there arise following symptoms:

• Headache.
• Cochleovestibular disorders.
• Visual impairment.
• Autonomic dysfunction.

Vertebrogenic pain has a burning, throbbing or aching character, they intensify in paroxysms, spreading from the back of the head to the parietotemporal and frontal zone. Cochleovestibular disorders include dizziness, unsteadiness and unsteadiness of gait. Visual impairment is manifested by darkening, flashing “spots” or “zigzags” before the eyes (photopsia). This may be accompanied by autonomic reactions such as a feeling of heat, increased sweating, and increased heart rate.

With persistent and severe stenosis, acute and transient disturbances are observed cerebral circulation, leading to the appearance of foci of ischemia. Transient attacks do not last more than 48 hours and are characterized by:

• Dizziness.
• Ataxia (coordination disorders).
• Nausea, vomiting.
• Speech disorders.

In addition, sensory disturbances in the form of numbness and crawling “goosebumps” around the mouth, in the upper or lower extremities are possible. As a rule, this symptom is unilateral, appearing with left or right vertebral artery syndrome.

If the stenosis is of vertebrogenic origin, then transient ischemic disorders can be detected during movements in the neck. Thus, patients often experience sudden falls while maintaining consciousness (drop attacks) or fainting (syncope). After such an attack, general weakness, lethargy, headache, tinnitus, flickering “spots” in the eyes, and sweating are noted.

With vertebral artery syndrome, a combination of various clinical variants of hypoxic-ischemic disorders in the structures of the brain is observed.

Additional diagnostics

Vertebral artery syndrome requires careful differentiation from other conditions that have similar symptoms. Polymorphism clinical picture complicates the formation of a preliminary conclusion - there is a risk of both under- and over-diagnosis. But along with this, the doctor is necessarily focused on the results additional research, allowing to identify changes in the spine, the vessel itself or surrounding soft tissues. These include:

• with functional load.
• Tomography (magnetic resonance, computer).
• Ultrasound with Dopplerography.

Only if all the clinical and instrumental signs are present can we confidently say about vertebral artery stenosis and count on its adequate treatment.

Treatment

To effectively treat vertebral artery syndrome, you need to know its cause. Based on the variety of pathological processes and mechanisms contributing to stenosis, therapy is characterized by a wide range of effects using various methods and methods. But each case is, of course, individual, and the approach to the patient should be carried out through the prism of all the characteristics of the body, and not just taking into account the degree of narrowing.

Medication

Great importance In the treatment of vertebral artery syndrome, medications are used. The list of drugs used in such patients is quite impressive, since it is necessary to act not only on clinical symptoms or altered structures of the spine, but also on the vessel wall, blood flow in it and brain tissue susceptible to hypoxia. Therefore, the following medications are used:

• Non-steroidal anti-inflammatory drugs (Xefocam, Larfix,).
• Muscle relaxants (Mydocalm).
• Decongestants (L-lysine escinate).
• Vascular (Latren, Actovegin).
• Antispasmodics (No-spa).
• Metabolic (Mexidol, Cytoflavin).
• Neuroprotectors (Cortexin).
• Venotonics (Detralex, Troxevasin).
• Chondroprotectors (Dona, Artra).
• Vitamins (Milgamma,).

Severe pain syndrome can be relieved using paravertebral blockades with Novocaine and glucocorticoids (Diprospan). They also have a certain significance local forms medications (ointment, gel, cream).

Drug treatment of vertebral artery syndrome is carried out in strict accordance with the recommendations of a specialist. You cannot deviate from medical prescriptions, because the final effect depends on this.

Non-drug

Among the conservative measures used in patients with vertebral artery stenosis, non-drug agents are widely used. They affect factors of external compression of the vessel, surrounding tissues, improve cerebral blood flow and have a general tonic effect. They use these healing methods:

• Physiotherapy.
• Gymnastics.
• Massage.
• Manual therapy.

It must be remembered that active influence on the spine should be carried out only after the elimination of acute phenomena, since otherwise the symptoms of the pathology will only worsen. This concerns physical therapy with post-isometric exercises, and manual therapy. You should wait until the full effect of the use of medications appears.

Surgical

To completely eliminate the basis of vertebrogenic syndrome, in many cases it is necessary to seek help from surgeons. Operationally eliminate space-occupying formations protruding into the spinal canal (osteophytes, hernias), thus decompressing the artery. Sometimes it is necessary to perform a resection of the sympathetic nerve plexus, and in case of internal blockage, vascular techniques are used to remove blood clots and plaques.

The effectiveness of treatment largely depends on timely implementation diagnostic measures. Regardless of the causes of stenosis - spinal-related or non-vertebral - the appearance of clinical symptoms should be a reason to consult a doctor. A specialist will determine their origin and prescribe appropriate therapy.

Article publication date: 06/28/2017

Article updated date: 12/21/2018

From this article you will learn what vertebral artery syndrome has cervical osteochondrosis symptoms, as well as its causes and effective treatments.

Vertebral artery syndrome is a set of symptoms that appear due to narrowing of the lumen of the left and/or right vertebral artery. The complex of symptoms includes: pain, dizziness, hearing and vision impairment, feeling hot, increased sweating. Most often this pathology occurs with cervical osteochondrosis.

This syndrome is dangerous because if left untreated it can lead to disability.

It is possible to cure it completely by surgically eliminating the cause of the narrowing of the artery lumen. You can relieve symptoms and slow down the further development of the syndrome with the help of medications and therapeutic exercises.

To select effective treatment, consult a neurologist.

Why does the syndrome develop?

The most common development is vertebral artery syndrome with cervical osteochondrosis. With this disease, growths called osteophytes appear on the vertebrae. They compress the blood vessels.

Occlusion (overlap) of the rotatory vertebral artery

Osteochondrosis in modern world– is no longer the lot of older people. Doctors detect the first signs of this disease even in teenagers. This is due to the unfavorable radiation background (echoes of the Chernobyl accident still affect health) and widespread among people of any age sedentary life.

The syndrome can also occur against the background of an intervertebral hernia of the cervical spine.

Another one common reason– atherosclerosis. In this case, the lumen of the artery narrows due to the growth of cholesterol deposits on the inner wall of the vessel.

Other less common causes of vertebral artery syndrome include:

• Defects in the structure of the spine (for example, Kimmerly’s anomaly, in which in the structure of the first cervical vertebra there is an additional bone formation (arch) that puts pressure on the vessel).
• Previous neck injuries with vertebral displacement.
• Thrombosis of the vertebral artery.
• Inflammatory diseases (arteritis) of this vessel.

Two stages and symptoms of pathology

There are 2 main stages of the syndrome:

1. Functional. At this stage, blood circulation in the brain is slightly impaired. There are no areas of the brain that constantly suffer from a lack of blood supply.
2. Organic. Certain areas of the brain are in conditions of constant lack of blood supply, which can lead to irreversible changes.

Symptoms at different stages

The functional stage can be recognized by the following features:

• Headache. Permanent. They are aching, burning or pulsating in nature. The main localization of pain is the occipital zone. May spread to temples, forehead. It gets worse when you move your head and in the morning if you sleep in an awkward position or on a pillow that is too high. May increase spontaneously.
• Dizziness. Appear in the form of attacks. The patient feels body instability and swaying.
• Hearing impairment. Minor (can be detected on an audiogram).
• Visual disturbances: sparks or “floaters” before the eyes, attacks of darkening in the eyes.
• Autonomic disorders: feeling hot or chills, excessive sweating, sleep disturbances.

Because many of these symptoms are common to other neurological disorders, the disease is often difficult to diagnose. initial stage. Vertebral artery syndrome can be confused with other disorders such as Meniere's syndrome.

Signs of the organic stage:

Possible complications

• The syndrome can provoke ischemic stroke.
• Also, against the background of a long course of the disease, severe discirculatory encephalopathy may develop.

Both complications are dangerous because they lead to disability.

Diagnostics

To identify the disease, you will need to undergo Doppler ultrasound of the neck vessels. This is an ultrasound examination of blood vessels. It is harmless, fast and accurate.

MRI or CT of the cervical spine is also used to determine the cause of the syndrome (osteophytes, hernia, etc.).

Difficulties in diagnosis

The syndrome is often difficult to correctly diagnose at the initial stage.

Difficulties in diagnosis do not appear at the stage of targeted examination (deviations from the norm are easy to notice on Doppler ultrasound), but at the stage of collecting symptoms.

It is easiest to diagnose vertebral artery syndrome in the presence of cervical osteochondrosis. If a patient complains of pain and stiffness in the neck, and also has at least a few of the symptoms listed above in this article, a neurologist can immediately assume this diagnosis.

In other cases, diagnosis is often difficult because the symptoms of the syndrome:

• Similar to signs of other neurological disorders.
• They are diverse and do not always appear all together.

Also, a patient may complain of only one group of symptoms (which is the most pronounced), but for some reason neglect other signs of the disease and not notice them. So, for example, if you are only talking about vegetative symptoms(feeling hot, chills, sweating, sleep disturbances), you may be misdiagnosed vegetative-vascular dystonia. And middle-aged women may even write off these symptoms as menopause and not see a doctor.

For correct diagnosis important:

1. Pay attention to own feelings and before visiting your doctor, make a list of all the symptoms that bother you (even if it seems to you that they are in no way related to each other).
2. Write down and later voice to the doctor even those symptoms that appear weakly, rarely, and do not indicate illness (in fact, this may not be the case).
3. Find good doctor using recommendations from friends.

Review of Treatment Methods

Drug treatment

The following groups of drugs are used to treat vertebral artery syndrome:

• Decongestants. With cervical osteochondrosis or a hernia of the cervical spine, not only the vertebral arteries are compressed, but also the nearby veins. This disrupts the venous outflow of blood, resulting in swelling. To relieve it, doctors recommend drugs that improve venous outflow: Diosmin, Troxerutin.
• Anti-inflammatory. These medications are needed to treat the underlying disease (osteochondrosis, arteritis). Doctors prescribe non-steroidal anti-inflammatory drugs such as Celecoxib, Nimesulide, Lornoxicam.
• . They stimulate blood flow in the vertebral artery, as well as in the small arteries and capillaries of the brain. A neurologist may prescribe you Pentoxifylline, Vinpocetine, Instenon, Cinnarizine, Vincamine or Nimidopine.
• Neuroprotectors. They strengthen neurons ( nerve cells) of the brain and prevent their death. Of the drugs in this group, Cerebrolysin, Actovegin or Piracetam are usually prescribed.
• Drugs that improve metabolism in cells: Trimetazidine, Mildronate.

They also use medications to eliminate negative signs that interfere with a normal life.

Symptomatic treatment:

Any drugs listed above can only be taken as prescribed by a doctor, as they have contraindications and side effects, and also require individual selection of the correct dosage.

Surgery

It is most effective because it directly affects the cause of the syndrome.

For diseases of the spine in modern medical practice successfully used:

• removal of osteophytes (growths on the vertebrae) for osteochondrosis;
• reduction of intervertebral hernias;
• removal of the bone arch for Kimmerly's anomaly.

If the narrowing of the lumen of the vertebral artery was caused not by its compression, but pathological processes in the vessel itself (atherosclerosis, arteritis), then resort to the following operations:

1. Endarterectomy is the removal of that section of the inner wall of the vessel on which the atherosclerotic plaque has grown.
2. Stenting is the installation of a stent inside a vessel - a special supporting and expanding frame.

After any operation, it will also be necessary to undergo drug treatment aimed at preventing recurrence of the disease that caused vertebral artery syndrome.

Therapeutic exercises are the key to spinal health

For vertebral artery syndrome with cervical osteochondrosis, drug treatment must be supplemented with physical therapy. It will help strengthen the neck muscles, relieve excessive tension and reduce the load on the spine.

Gymnastics is also indicated after surgery (after postoperative period) to prevent relapse of the disease.

Before starting gymnastics, consult your doctor, as not all exercises are suitable for you. For some diseases, tilting the head forward may be prohibited. Be sure to check this with your doctor.

Set of exercises

Perform all exercises slowly, without sudden movements. At the extreme position of each exercise, hold for 3 seconds (except for those indicated by an asterisk). Do everything 10 times on each side.

Forecast

The prognosis depends on the disease that caused the syndrome, as well as on the stage at which it was diagnosed.

With successful surgical elimination of the cause of the syndrome at its initial stage, as well as with compliance with all the doctor’s recommendations regarding further preventive measures, the prognosis is relatively favorable, patients can lead a normal life.

Extravasal compression of the vertebral arteries: symptoms, manifestations, diagnosis, therapy

Extravasal compression of the vertebral arteries is one of the causes of a whole complex of manifestations serious violations in the blood supply to the brain. The fact is that blood enters the brain through two main channels: the carotid (two carotid arteries) and the vertebrobasilar (two vertebral arteries). In cases where the functions of one or more of these blood vessels are disrupted, normal nutrition of the brain stops: it receives an insufficient amount of useful substances, also oxygen, and the patient in this case suffers from a whole complex of neurocirculatory disorders known as. It's complicated medical concept needs to integrated approach and careful identification of the root cause of the disease, since the process of making a correct diagnosis is quite complex and requires a comprehensive examination of the patient.

For supplying blood to the brain, cerebellum and inner ear respond to arteries originating from subclavian arteries. They are located in a special channel, in cervical vertebrae, close to the elements of the spinal column. Therefore, if the structure of the spine is disturbed, there is a danger of reducing the lumen of the channel through which this blood vessel passes - there is a possibility of extravasal influence of nearby tissues on it, its compression and disruption of blood flow.

Signs and main causes of PA syndrome

With extravasal compression of the vertebral arteries (left, right or both), they are compressed intervertebral hernia, tumors of various etiologies, other anomalies in the structure of the cervical vertebrae. As a rule, compression of the artery develops at the level of 4-5 cervical vertebrae. Whatever the reason, stenosis (narrowing of the lumen of the vessel) can cause disruption in the normal flow of blood to the brain.

photo: possible reasons extravasal compression of VA

The main feature of this complex disease severe incessant headaches, dizziness, vomiting, nausea. Headaches are usually localized in the cervical-occipital part, radiating to frontal lobes heads. This symptom is called “helmet removal pain.” It intensifies after sleeping on an uncomfortable pillow, with sudden movements of the neck, it can cause an attack and a shaking ride. There are different types of headaches - throbbing, shooting, aching. Pain is often felt when simply touching the scalp.

This disease is quite often accompanied by disturbances in the cochleo-vestibular apparatus: attacks of dizziness, a feeling of instability and staggering, a feeling of noise and ringing in the ears, decreased hearing, and nausea are possible. In complicated cases, loss of consciousness often occurs during sudden movement neck, sudden fall with preserved consciousness (drop attacks). It is also possible visual disturbances, which begin with increased eye fatigue, decreased vision under any visual load; sensations of pain, redness and lacrimation, a feeling of the presence of a foreign body in the eyes, flashing spots. There are frequent attacks when part of the panorama temporarily falls out of the field of vision when moving the head to the side, as a result.

The causes of these disorders are different: congenital, acquired as a result of heavy loads, during progression, or due to other factors. Depending on the location of pain and symptoms, patients are diagnosed with “Right VA Syndrome” or “Left VA Syndrome”.

Diagnosis of extravasal compression of the vertebral arteries

To clarify the diagnosis, the attending neurologist prescribes additional examinations, which should include the following procedures:

• MRI – magnetic resonance imaging, which allows to identify abnormalities of the bone bed of the vertebral artery (VA);
• SCT – reveals features and areas of compression of the blood vessel;
• X-ray of the cervical spine - allows you to identify herniated intervertebral discs or other formations that impede normal blood flow;
• Duplex scanning of the vertebral arteries - determines the nature of the lesions on the internal walls of the VA and allows you to determine the exact location of compression;
• Vertebral - with the help of this examination, you can determine the strength of blood flow and its deviation from normal values;
• Prescribed according to indications - injected into the artery contrast agent and using an X-ray machine, three-dimensional images of damaged vessels are taken.

The use of these diagnostic techniques in combination will allow us to determine the exact cause and localization of VA compression and prescribe appropriate treatment.

Video: blood flow problem in the vertebral artery on ultrasound

Methods used in the treatment of extravasal compression of the VA

The prescribed treatment should be aimed at reducing swelling and inflammatory process , which develop due to mechanical compression of a blood vessel. This is accompanied by a violation of venous blood flow - as a result, a mutual stagnation process develops. Thus, this factor must be taken into account in treatment. For this purpose, the neurologist should prescribe complex preparations, capable of restoring impaired hemodynamics. This stage is very important and responsible in the treatment of the disease, since incorrectly selected medicines can intensify its manifestations and even cause various kinds complications, including Doctors usually prescribe decongestants and non-steroidal anti-inflammatory drugs.

For severe headaches, the doctor may prescribe a novocaine blockade of the PA and sympathetic plexus. In some cases, if ineffective conservative treatment The doctor may decide to perform a surgical intervention, during which decompression of the vertebral column is performed, removal of osteophytes and growths that contribute to compression of blood vessels in the vertebral body. This complex operation is performed in specialized medical centers neurosurgeons with experience in performing such interventions.

After the removal of acute inflammatory phenomena, it is necessary to carry out special therapy aimed at regenerating damaged neurons and restoring brain functions affected by long-term oxygen starvation. Using these medications will help improve tissue microcirculation and blood supply to the entire brain stem. As a result, all important functional processes occurring in the brain should return to normal.

This stage of treatment is especially important for patients with increased risk development of transient ischemic attacks, if present, to prevent persistent neurological deficit and the development of secondary complications.

In addition to the main medical drugs patients should take antispasmodics, antiallergic drugs and multivitamins. You should definitely remember that all prescriptions must be made by a doctor - otherwise self-medication can lead to disastrous consequences.

Physiotherapeutic procedures for PA syndrome

You can't ignore one more important stage rehabilitation therapy - physiotherapeutic procedures. Good effect give massages of the collar zone, acupuncture procedures, other physiotherapeutic measures: UHF, electrophoresis with medicines and physical therapy activities aimed at relieving pain and other clinical manifestations of this disease.

Upon completion of the course of treatment, patients should undergo additional rehabilitation treatment in specialized sanatoriums or resorts, where it is possible to take hydrogen sulfide and radon baths, healing mud, professional massage affected area to consolidate the results of therapy.