CLINICAL FEATURES OF ACUTE AND CHRONIC VERTEBROBASILAR INSUFFICIENCY
Keywords:
vertebrobasilar insufficiency, acute VBI, chronic VBI, ischemia, vertigo, stroke, ataxia, neuroprotection, diagnosis, treatmentAbstract
The article presents an overview of current data on the clinical features of acute and chronic vertebrobasilar insufficiency (VBI). Pathogenetic mechanisms, main neurological syndromes, diagnostic approaches and current treatment methods are considered. Comparative characteristics of clinical manifestations of acute and chronic forms, as well as conditional clinical examples are given. Vertebrobasilar insufficiency (VBI) is insufficient blood flow through the posterior cerebral circulation, which is supplied by two vertebral arteries that merge to form the basilar artery. The vertebrobasilar vascular system is also known as the posterior circulation and supplies areas such as the brainstem, thalamus, hippocampus, cerebellum, occipital and medial temporal lobes. Stroke may result from either vertebral or basilar artery occlusion or from an embolus that lodges more proximally to the brain. In emergency settings, VBI is an important differential diagnosis to consider. Its presentation may share features with other etiologies including labyrinthitis, vestibular neuritis, and benign paroxysmal positional vertigo (BPPV). This event reviews the evaluation and management of vertebrobasilar insufficiency and highlights the role of multidisciplinary team members in collaboration to provide well-coordinated care and improve outcomes for patients with this condition.
References
Виноградова Т.Е., Парфенов В.А. Хроническая вертебробазилярная недостаточность // Неврология и психиатрия. – 2015. – Т. 7, №3. – С. 15–22.
Lima Neto AC, Bittar R, Gattas GS, Bor-Seng-Shu E, Oliveira ML, Monsanto RDC, Bittar LF. Pathophysiology and Diagnosis of Vertebrobasilar Insufficiency: A Review of the Literature.Int Arch Otorhinolaryngol. 2017 Jul;21(3):302-307.
Caplan L.R. Posterior circulation ischemia: clinical features and management. – Springer, 2015. – 420 p.
Lee H. Isolated vascular vertigo // J. Stroke. – 2014. – Vol. 16(3). – P. 124–130.
Yuh SJ, Alkherayf F, Lesiuk H. Dolichoectasia of the vertebral basilar and internal carotid arteries: A case report and literature review. Surg Neurol Int. 2013;4:153.
Стаховская Л.В. Инсульт: диагностика, лечение, профилактика. – М.: ГЭОТАР-Медиа, 2016. – 512 с.
Compter A, van der Worp HB, Schonewille WJ, Vos JA, Boiten J, Nederkoorn PJ, Uyttenboogaart M, Lo RT, Algra A, Kappelle LJ., VAST investigators. Stenting versus medical treatment in patients with symptomatic vertebral artery stenosis: a randomised open-label phase 2 trial. Lancet Neurol.2015 Jun;14(6):606-14.
Raheja A, Taussky P, Kumpati GS, Couldwell WT. Subclavian-to-Extracranial Vertebral Artery Bypass in a Patient With Vertebrobasilar Insufficiency: 3-Dimensional Operative Video. Oper Neurosurg. 2018 Mar 01;14(3):312.
Черникова Л.А. Современные методы нейровизуализации при ВБН. – М.: Практика, 2015. – 192 с.
Najafi MR, Toghianifar N, Abdar Esfahani M, Najafi MA, Mollakouchakian MJ. Dolichoectasia in vertebrobasilar arteries presented as transient ischemic attacks: A case report. ARYA Atheroscler. 2016 Jan;12(1):55-8.
Трубачев В.В. Роль артериальной гипертензии в развитии ВБН // Неврология. – 2014. – №6. – С. 22–27.
Савицкий А.Н. Дифференциальная диагностика головокружений. – Минск: Беларусь, 2014. – 184 с.
Kernan W.N., Ovbiagele B., Black H.R. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack // Stroke. – 2014. – Vol. 45. – P. 2160–2236.
Трубникова Л.А. Роль когнитивных нарушений при хронической ишемии мозга // Вестник неврологии. – 2017. – №9. – С. 42–49.
Buch VP, Madsen PJ, Vaughan KA, Koch PF, Kung DK, Ozturk AK. Rotational vertebrobasilar insufficiency due to compression of a persistent first intersegmental vertebral artery variant: case report.J Neurosurg Spine. 2017 Feb;26(2):199-202.
