Vertebral arteries extend from the subclavian large vessels. These channels feed the brain. In particular, the occipital lobes, cerebellum, and trunk are supplied with blood. Next, we analyze in more detail what constitute the vertebral arteries. The article will describe vascular dysfunctions, the clinical picture and therapeutic methods used to eliminate them.
General information
Segments of the vertebral artery pass through a channel formed by the transverse processes of the cervical bone elements. The vessels got their name for their location. Penetrating into the cranial cavity through the occipital foramen, the vertebral arteries merge at the brain stem into the basilar canal. From this section they go up. Branching occurs under the cerebral hemispheres. On the one hand, the right passes, and on the other, the left vertebral artery.
Anatomy
Each channel is divided into specific parts. The following segments of the vertebral artery are distinguished:
- Intracranial . This section passes through the cranial cavity to the point of confluence of the branches and the formation of the basilar canal.
- Cervico-occipital. This segment runs from the exit from the canal of the processes of (transverse) vertebrae (cervical) to the entrance to the cranial cavity.
- Cervical . This site passes along the canal of the processes (transverse) of the cervical vertebrae.
- Prevertebral . This is the lowest section. The segment runs from the place of discharge of the vertebral vessel from the subclavian to the entrance to the canal of the processes of the vertebrae of the cervical spine.
Blood supply to the head
The brain feeds two pools: vertebrobasilar and carotid. The latter includes carotid arteries (internal). They provide from 70 to 85% of the total blood volume. Carotid arteries are responsible for almost all major circulatory disorders of the brain. This primarily relates to strokes. In this regard, during the examination, their condition is given special attention. Their atherosclerotic lesions and the consequences of this are an object of increased interest to cardiologists, as well as neurologists and vascular surgeons. The vertebrobasilar pool includes both the right and left vertebral artery. They provide about 15-30% of the total blood volume. Such a defeat as a stroke can seriously harm the patient, even make him disabled.
Circulatory disorders
Vertebral arteries and their branches feed the cerebellum. With a lack of blood supply, dizziness is likely. This symptom of the vertebral artery is called vertebrobasilar insufficiency. Through the vessels in question, the brain stem is supplied . The vital centers of respiration and blood circulation are concentrated in this structure. In this regard, a stroke in this area is quite difficult and often leads to death. Great danger is cervical osteochondrosis. Vertebral artery syndrome develops due to deformation of bone elements. The vessels become sinuous, which leads to a violation of the blood supply.
Causes of Violations
Factors provoking pathological conditions can be vertebrogenic and non-vertebrogenic in nature. In the latter case, we are talking about injuries that do not have a connection with the spine. They are caused by congenital anomalies in the size and course of blood vessels or atherosclerosis. But the last reason is rarely diagnosed. These anomalies do not have independent significance. But due to the attachment of other factors of compression of the arteries, a very unfavorable condition is formed.
Vertebrogenic lesions are caused by various pathologies of the spine (osteochondrosis - mainly). These disorders can occur even in childhood or adolescence against the background of dysplastic or post-traumatic instability in the cervical spine. As a result, vertebral arteries can be deformed.
Symptoms of circulatory failure
The most characteristic sign of pathology is a constant, in some cases paroxysmally agonizing, excruciating throbbing pain in the head. As a rule, it is localized in the occipital area. During the attack, soreness can spread to other areas. Most often, it gives to the region of the eye socket and nose bridge, to the parietal-temporal region, to the forehead or ear. Soreness can be either paroxysmal or permanent. Sensations are usually localized on one side.
Often there is soreness of the scalp. This sensation appears even with a slight touch, combing. When turning or tilting the head, a characteristic crunch may occur, in some cases there is a burning sensation.
In some cases, patients with vertebral artery syndrome develop dizziness, accompanied by nausea or vomiting, hearing loss, ringing / tinnitus, and various visual impairments. The latter should include such manifestations as the appearance of a shroud or fog in front of the eyes, double vision, opacification, and others. Rarely do patients complain of a feeling of the presence of a foreign body in the throat (pharyngeal migraine) and difficulty swallowing. Among vegetative disorders, a short feeling of hunger, thirst, a feeling of heat or chills can be observed.
Defeat of the sympathetic plexus
In this case, Bernard-Horner syndrome is noted . The condition is accompanied, as a rule, by unilateral pain and paresthesias. Symptoms usually capture the face, hard palate, teeth, tongue. A tingling, burning sensation, a feeling of the presence of an alien body appears in the throat. In addition to these symptoms, vestibular-type disorders are observed in the form of dizziness, swaying, and failing. These disorders are accompanied by nausea and ringing or noise in the ear. In the course of headache attacks, chills appear, working capacity decreases, sweating increases, fatigue increases, visual acuity decreases, and “flashing flies before the eyes” appears. With any change in the position of the head, the intensity of pain increases significantly. But at the same time, the patient can find a position in which this sensation significantly decreases or disappears completely.
Congenital malformation
Hypoplasia belongs to this category of pathologies. The left vertebral artery is not affected so often. Signs of pathology are not immediately observed. Symptoms are closely associated with hemodynamic disorders. This means that before stagnation and inadequate blood flow become clinically significant, a certain amount of time must pass. It should be remembered that in the human body there are compensatory mechanisms that allow to maintain normal nutrition during a given period.
Causes of anomalies
Why does hypoplasia develop? The left vertebral artery may form incorrectly in the prenatal period for several reasons. The main ones include:
- Bruises, falls of a woman during gestation.
- Antenatal use of alcohol, certain medications, drugs, and smoking.
- Infectious diseases transferred during pregnancy.
- Burdened by heredity.
Against the background of hypoplasia, a significant narrowing of the lumen of the artery is noted at the site of its entry into the canal leading to the cranial cavity.
Diagnostics
The identification of pathology involves the use of several research methods. First of all, the specialist in his conclusions is based on the clinical picture. In this case, we are talking about information obtained during a neurological examination, as well as patient complaints. Diagnosis often reveals tension of the occipital muscles, difficulty turning the head, pain when pressing on the processes of 1 and 2 vertebrae in the cervical spine. Radiography is also used during the examination. An obligatory measure is MRI. This procedure allows you to identify the exact cause of circulatory disorders, to detect the site of compression of the vessel. One of the main diagnostic methods is ultrasound dopplerography. During the diagnosis, the specialist must differentiate the syndrome with migraine.
Therapeutic measures
If blood circulation is impaired (the vertebral artery is narrowed or deformed), treatment is usually prescribed as a complex. Therapeutic measures depend on the age of the patient, the severity of the condition, as well as the individual characteristics of the patient. Due to the fact that such patients are at risk for stroke, therapeutic measures are primarily aimed at eliminating blood supply disorders and vasospasm. The complex uses vacuum treatment, pharmacopuncture. In addition, reflexology, a number of medications are prescribed. Among the drugs indicated for use are mild antidepressants and anti-inflammatory drugs. Recommended medicines such as Aminophylline, Cinnarizine, Cavinton. In case of dizziness, Betagistin is prescribed.
In case of detection of circulatory disorders of the brain or spinal cord during the examination, hospitalization of the patient is recommended. In the absence of an acute need for a hospital stay, a specialist may recommend the temporary wearing of a Shants collar. This corset is used to reduce the load on the cervical spine. Against the background of vertebral artery syndrome, manual therapy, physiotherapy and acupuncture, electrophoresis with analgesics, phonophoresis, and diadynamic currents are often prescribed .