In the list of health disorders associated with cervical osteochondrosis, a special place is occupied by the so-called vertebrobasilar syndrome. This is special because, along with other disorders of cerebral circulation, this pathology not only reduces the patient’s quality of life, but, without timely treatment, can pose a serious threat to the patient’s health and well-being.
What is vertebrobasilar syndrome?
With vertebral artery indroma in cervical osteochondrosis , it is a complex of disorders resulting from hemodynamic disturbances in the vertebral artery basin. This condition is one of the complications of cervical osteochondrosis, which , due to the specifics of the anatomical features of the vertebral artery, can lead to impaired functioning of almost all organs and systems.
The close attention to this pathology is due to the fact that, in addition to subjective discomfort (pain, dizziness, vision problems), vertebrogenic syndrome can negatively affect the vital functions of several structures of the central nervous system, which causes health and life-threatening conditions.
Causes of occurrence
The reasons for the development of this pathology lie in the anatomical features of the cervical spine and, in particular, the artery itself . This paired vessel is a branch of the subclavian artery. Approaching the sixth cervical vertebra , the vertebral artery enters the canal formed by the processes of the cervical vertebrae (from the first to the sixth) . From this channel, the vertebral artery enters the skull .
Lying in the bone canal, the vertebral artery is prone to deformation at the slightest instability of the cervical vertebrae , as well as with a decrease in the height of the intervertebral discs.
Mechanisms for the development of vertebrogenic syndrome:
- Due to deformation of the artery, the volume of blood flow through it decreases, which leads to a violation of the blood supply to the basal structures of the brain.
- Another mechanism for the development of pathological symptoms associated with cervical osteochondrosis is irritation or even infringement of the sympathetic nerve bundle, which runs along with the vertebral artery. Injury to nerve fibers leads to the rapid development of neurological symptoms.
So the pathological symptom complex is formed, better known as vertebral artery syndrome against the background of cervical osteochondrosis .
Risk factors
There are a number of conditions in the presence of which it is more likely that vertebral artery syndrome occurs with cervical osteochondrosis (the causes of the disease lie in the pathology of the spine) , these are:
- With am osteochondrosis.
- And the excess body weight characteristic of obesity.
- Systemic diseases accompanied by metabolic disorders (diabetes mellitus, atherosclerosis).
- H excessive emotional stress and physical exertion.
- With toxic toxic effects (alcohol, nicotine).
- Genetically determined predisposition to vascular disorders.
Clinical manifestations
The symptoms of this vascular pathology are very recognizable:
Pronounced prickly headaches, characterized by a pulsating character and spreading from the back of the neck to the back of the neck, and from there - towards the temples and frontal region. More often, headache with vertebrogenic syndrome has unilateral localization.
- Bleeding sensations localized directly on the surface of the scalp.
- Disturbances from the vestibular apparatus : a sense of instability as when walking , as well as at rest, swaying, episodes of dizziness, hearing loss, audible extraneous sounds in the form of ringing or tinnitus. " Floating out from under the feet" with sharp turns of the head.
- Subjective reduction in visual acuity due to flickering sparks, flies, fog or shroud in front of the eyes , sand sensation in the eyes.
- Tension and soreness of the neck muscles (especially during palpation) .
- Episodes of numbness of any part of the face.
- Disorders in the cardiovascular area from the phera in the form of episodes of tachycardia, soreness behind the sternum, a feeling of lack of air during inspiration.
- Psychological manifestations in the form of attacks of aggression, panic attacks, depressive states or a tendency to apathy.
In addition to high blood pressure, often accompanying vertebral artery syndrome in cervical osteochondrosis , the main symptoms of this vascular disorder in severe cases can be accompanied by the following symptoms:
- T nausea arising at the height of the attack and ending with vomiting.
- Cracking and crunching when making movements in the cervical region - tilting and turning the head.
- Strengthening of pathological phenomena from the side of vision: double vision, narrowing of the field of vision, fuzzy visibility.
- The progression of hearing impairment and increased pathological noise.
- Disruption of swallowing.
- Deterioration of sensitivity of the skin of the lips, mucous membrane of the tongue and pharynx; numbness and paresthesia in these areas.
- Loss of consciousness. Often this condition is preceded by a backward position of the head (as, for example, when looking up). The approach to loss of consciousness can be recognized by increased nausea and dizziness, impaired speech, and a sharp loss of vision in one of the eyes.
These signs, combined with soreness and other signs of exacerbation of cervical pathology, almost unmistakably indicate vertebral artery syndrome in cervical osteochondrosis .
Diagnostics
The variety of subjective signs of vertebrogenic syndrome and the different perception of complaints by different patients significantly complicates the diagnosis of vertebrobasilar syndrome . In this regard, a list of compulsory examinations was developed to identify objective signs characteristic of this pathology.
- Dplex scanning or ultrasound dopplerography of arteries in order to detect extravasal deformities of the vertebral artery.
- X-ray of the cervical vertebrae using functional tests and image fixation during flexion and extension of the cervical spine.
- M RT (m -resonance imaging ) , revealing the presence, degree and localization of deformities of blood vessels.
Vertebral artery syndrome in cervical osteochondrosis is diagnosed when the patient identifies three main clinical criteria:
- The presence of a set and combination of symptoms characteristic of this pathology.
- The typical changes revealed by the methods of magnetic resonance imaging and X-ray diffraction .
- Typical abnormalities detected during scanning, as well as during dopplerography of the vertebral arteries using stress tests, with bending and extension of the head.
Such a list of diagnostic criteria was established in order to avoid overdiagnosis of vertebrogenic syndrome.
The importance of differential diagnosis
Sharp bouts of headaches, combined with dizziness and nausea due to a rise in blood pressure, as well as the likelihood of loss of consciousness may indicate a stroke in a vertebro- basilar pool , a transient ischemic attack or an infectious toxic lesion of neural tissue during neuroinfection , as well as a syndrome vertebral artery with cervical osteochondrosis. Symptoms occur suddenly, making it difficult to collect an anamnesis. Both conditions belong to the category of emergency and are an indication for hospitalization and a detailed examination.
Differential diagnosis is necessary for the correct selection of treatment for each of these diseases .
Drug therapy
With vascular pathology, which also includes vertebral artery syndrome in cervical osteochondrosis , treatment must necessarily be comprehensive and not only affect the etiology, but also focus on the correction of disorders resulting from circulatory disorders.
- The first step in drug treatment is the selection of non-steroidal anti-inflammatory drugs to eliminate neurogenic inflammation. Priority is given to drugs from the selective type NSAID group that block only the second type cyclooxygenase enzyme ; this approach combines efficacy in combating the disease with safety for the patient. Typical representatives of this group of drugs are drugs based on nimesulide , meloxicam, or celecoxib .
- A number of disorders that cause the symptoms in vertebral syndrome develops under the influence of pathological hypertonicity of the muscles of the neck and. This is one of the signs that we are facing vertebral artery syndrome in cervical osteochondrosis. Patient reviews indicate that the inclusion of muscle relaxants in the treatment regimen contributes to a more rapid normalization of well-being and general condition. From the group of such drugs, “M idokalm” , “C irdalud” , “B aclofen” give a good effect . Eliminating muscle spasm, muscle relaxants reduce the intensity of the pain syndrome, thereby reducing the need for non-steroidal anti-inflammatory drugs. An important point! During the period of use of these medicines, one should refrain from activities requiring increased attention and quick reactions. In addition, such work is incompatible with vestibular disorders, which manifests vertebral artery syndrome in cervical osteochondrosis .
- Treatment of conditions caused by malfunction of hemodynamics in the vertebrobasilar basin is inconceivable without the use of drugs that normalize mycirculation , bioactive substances, and other drugs whose action is aimed at combating tissue hypoxia.
Physical methods
As an independent medical technique, physiotherapy is insufficiently effective ; vertebral artery syndrome in cervical osteochondrosis requires an integrated approach to treatment. However, as an auxiliary physiotherapy gives pretty good results.
The disadvantage of this method is that its use is contraindicated in the period of exacerbation of osteochondrosis.
Massage with vertebrogenic syndrome is often contraindicated even during remission, as it can cause displacement of the vertebrae and impairment of the neurovascular bundle.
The preferred method for this pathology is reflexology, which can relieve muscle cramps without causing harm to the patient and without aggravating his condition.
The orthopedic regimen ( immobilization of the cervical spine by wearing a Shants collar) is of no small importance . This point is especially important in cases when the deteriorating state of the patient is associated with a change in position or head movements.
Without exacerbation, it is necessary to take a set of measures to strengthen the muscular frame of the neck. In connection with the specifics of the pathology, the decision on the feasibility of exposure through massage or exercise therapy should be made by a specialist. Exercises should also be performed under the supervision of a specialist.
Folk methods
Among the recipes containing popular experience in the treatment of certain disorders, there are also tools that help to cope with some manifestations of vertebrogenic syndrome.
- The use of garlic to reduce blood viscosity. To obtain a medicinal composition, three large heads of garlic must be chopped and aged in the dark for three days. Then the mass must be filtered and add to it in equal amounts of honey and lemon juice. P and t at bedtime on a tablespoon.
- The reduction in blood pressure will be facilitated by the administration of a composition prepared from 40 grams of corn stigmas, 20 grams of lemon balm, lemon juice and a glass of boiling water. After an hour of insisting, take half a cup three times a day 30 minutes before meals.
Keep in mind: in such a serious situation as vertebral artery syndrome in cervical osteochondrosis, the causes of the disease and numerous disorders are not eliminated by herbal infusions or other folk remedies. A full treatment regimen can be prescribed only by the attending physician after a detailed examination of the patient. Folk remedies are used as auxiliary; their use is permissible subject to the following conditions:
- About the absence of allergic reactions to the ingredients .
- About the absence of contraindications and approval of the attending physician.
Indications for surgical treatment
The decision on surgical intervention is made in case of development of the following pathological conditions due to vertebrogenic syndrome :
- And shemic attacks, strokes .
- And intellectual- mnestic , cognitive disorders .
- The rapid progression of visual , hearing and balance disorders .
In addition, cases where the vertebral artery syndrome in cervical osteochondrosis is combined with severe arterial hypertension, anatomical abnormalities of the vertebral artery or atherosclerosis, as well as the ineffectiveness of therapeutic measures are recognized as indications .
Complications
The most formidable complication of vertebrobasilar syndrome is stroke in the vertebrobasilar pool. Its consequences can be:
- And the loss of hearing.
- Total loss of vision.
- With cardiovascular failure.
- Respiratory failure.