Vascular stenosis in the cervical region: causes and symptoms of pathology. Narrowing of the vertebral arteries

3.1 Medical treatment.
The optimal management of patients with atherosclerotic PA disease is not as well understood as the management of patients with CA disease. There has not been a single large randomized trial, despite numerous surgical, interventional and medical approaches to the treatment of this category of patients. In fact, only a few studies on ischemic stroke have differentiated between anterior and posterior (vertebrobasilar) NCM. However, despite the lack of evidence specifically applicable to patients with PA diseases, it is reasonable to treat these patients with the same treatment as patients with CA lesions. The same measures should be aimed at preventing the progression of atherosclerosis in other vascular pools.
A study of the use of intravascular thrombolysis in patients with acute ischemic syndrome in VBB showed different outcomes of this treatment method. Thus, it is advisable to prescribe anticoagulants for a period of at least 3 months. In patients who have an angiographic diagnosis of thrombosis of the orifice or extracranial segment of the VA, regardless of whether thrombolysis was used initially or not. The WASID study showed that warfarin and aspirin are equally effective immediately after the onset of non-cardioembolic stroke, while ticlopidine proved to be superior to aspirin as a secondary prevention of ischemic events in patients with VBI. In the ESPS-2 study, 5.7% of 255 patients who received low-dose aspirin in combination with dipyridamole twice daily developed a stroke or TIA in VBI, compared with 10.8% of patients who received placebo.
3.2 Surgical treatment of diseases of the vertebral arteries.
In comparison with CEA, operations for occlusive diseases of the VA are rarely performed. Despite the fact that no randomized trials have been conducted, reports on the surgical treatment of PA show good results in endarterectomy and other reconstructive operations on the PA. During the reconstruction of the proximal portion of the VA, early complications develop in 2.5–25.0% of cases, lethal outcomes reach 4%, and during the reconstruction of the distal VA, 2–8%. Intracranial shunting is accompanied by mortality from 3 to 12%, neurological and systemic complications - from 22 to 55%.
Clinical indications for surgical interventions for PA lesions are primarily TIA and stroke in VBB. The natural course of chronic VBI with tortuosity, extravasal compression or VA stenosis rarely leads to the development of a stroke, therefore, the goal of surgical treatment for VA lesions in this category of patients is to achieve clinical efficacy, that is, regression of the clinical manifestations of VBI with the ineffectiveness of drug treatment for at least 3 -6 months
Indications for surgical treatment of PA are determined by three criteria:
Thorough diagnosis of PA lesions by ultrasound, TKDG, CDS, which must be confirmed using MRA, MSCTAG or radiopaque angiography.
Accurate definition of what exactly the pathology of PA is the main cause of the clinical manifestations of VBI or plays a leading role in its development.
VBI resistance for six months to complex drug therapy.
If a PA lesion is detected, but in the absence of clinical manifestations, surgical treatment is not indicated.
Indications for surgical treatment of VA are VA occlusion, VA stenosis over 70%, pathological tortuosity, and extravasal compression.
Clinical indications for surgical treatment for VA occlusion are essentially the same as for stenosis, but are established more often due to the greater severity of clinical manifestations and the significantly lower effectiveness of drug treatment.
Surgical treatment is indicated only for a small part of patients with clinical manifestations of VBN (no more than 5%), and in most cases the task of the operation is to eliminate circulatory failure associated with stenosis of the lumen of the vertebral artery, its extravasal compression or spasm in combination with lesions of other arteries supplying the head brain. In the event that both VAs are patent and there is a significant lesion of one artery, then the contralateral VA usually provides compensation for blood flow through the basilar artery, especially in cases where the unaffected artery is dominant, that is, it has a larger diameter. In the development of cerebellar stroke, not only a decrease in the perfusion of the VBB plays a role, but also material embolism in case of damage to the orifice of the VA.
Possible operations for stenosis, tortuosity and extravasal compression of the VA are:
Transsubclavian endarterectomy PA;
Endarterectomy of the orifice of the VA with isthmoplasty using an autovenous or synthetic patch;
Ligation of the mouth of the VA with transposition of the artery trunk at the mouth of the thyroid trunk;
Ligation of the PA mouth with transposition of the artery trunk into the common carotid artery;
Ligation of the orifice of the PA with transposition of the artery trunk into the newly formed orifice on the subclavian artery;
Shunting of the VA with the internal mammary artery;
Arteriolysis of the mouth of the VA, scalenotomy, stelectomy;
Angioplasty PA;
PA angioplasty with stenting.
Operations for transposition of the PA into the ipsilateral CCA or onto the stump of the thyrocervical trunk are currently considered preferable due to the best long-term results.
Surgical treatment of VA occlusion is a complex and not yet fully resolved problem. Occlusion of the VA at the mouth is not subject to reconstruction and is most often accompanied by its lesion in the bone canal. In this regard, in case of extracranial occlusion of the VA, the state of the VA segment III is decisive in determining the indications for reconstructive surgery. If it is patent, it is possible to perform arterio-arterial or autovenous shunting between the ipsilateral ECA and VA. Evaluation of the patency of the III segment of the VA with occlusion of its mouth is possible only with a combined assessment of the data of radiopaque angiography, ultrasound, TKDG and CDS.
3.3 Transcatheter endovascular interventions on the vertebral arteries.
Despite the fact that endovascular interventions are technically simple and, as in the case of CA lesions, are indicated for high-risk patients, to date there are no randomized trials proving their superiority over open interventions. According to the analysis of 300 interventions on the proximal segment of the VA, the risk of death was 0.5%, intraoperative complications - 5.5%, postoperative stroke - 0.7% with an average follow-up of 14.2 months. Restenoses occurred in 26% of cases (from 0 to 43%) within 12 months. (from 3 to 25 months) observations, however, the frequency of restenosis did not always correlate with the frequency of recurrence of clinical symptoms. Out of 170 patients with lesions of the distal segments of the vertebral arteries who underwent angioplasty, neurological disorders occurred in 20% of cases, however, in 80% of them, the procedure was performed for urgent indications. Restenoses developed in 10% of cases with an average follow-up period of 12.6 months. Data from 14 studies show that the annual risk of stroke after angioplasty for a distal lesion is about 3%, and the risk of stroke and re-restenosis is higher the more distal the arterial lesion is.
CAVATAS, the only randomized trial comparing the results of endovascular and medical treatment, included only 16 patients with VA lesions and 504 with CA lesions. And since none of the patients with VA pathology had recurrent disorders in the VBB within 8 years after randomization, it was not possible to identify differences in the long-term results of stenting and medical treatment. The low level of diagnostics of symptomatic VA lesions, in comparison with carotid ones, illustrates the difficulties in assessing the success of vertebral artery revascularization.
3.4 Recommendations on the tactics of treatment for lesions of the vertebral arteries.
Surgical interventions on the vertebral arteries should be, first of all, therapeutic in nature and be aimed at stopping the clinical manifestations of vertebrobasilar insufficiency.
In case of II and IV degrees of cerebrovascular insufficiency in the VBB, indications for surgical interventions are recommended to be determined by analogy with carotid artery stenoses, but taking into account the degree of compensation of blood circulation in the VBB through the contralateral VA and the degree of blood flow decompensation in the basilar artery.
In chronic VBN (III degree of cerebrovascular insufficiency), surgical interventions on the vertebral arteries are recommended only after unsuccessful conservative therapy for 3–6 months.
Asymptomatic patients with isolated VA stenoses are recommended to be treated conservatively. Surgical treatment in asymptomatic patients with VA stenoses is recommended only in case of combined damage to the CA and VA, in situations where surgical interventions on the CA are impossible.
In the diagnostic algorithm for determining indications for surgical interventions on PA, it is recommended to include one of the non-invasive imaging methods: CDS, MRA, or MSCTAG. In patients with clinical manifestations of VBI, MRA and CTA should be prescribed more often and earlier than ultrasound methods for examining PA.
In patients with VBI who are scheduled to undergo revascularization surgery on the vertebral arteries, it is recommended to perform a standard angiographic study in cases where non-invasive methods did not help to reveal the pathology and exact localization of the lesion, as well as the degree of VA stenosis.
In patients who have already undergone VA reconstructive surgery, it is recommended to perform periodic follow-up studies, as well as after carotid reconstructions.
Level of evidence C.
Drug therapy and lifestyle changes are recommended to reduce the influence of risk factors for the development of VA atherosclerosis according to the standards recommended for patients with CA atherosclerosis.
Level of evidence B.
Antiplatelet therapy is recommended for patients with a history of stroke or TIA and PA involvement. Aspirin (50-100 mg/day), combinations of aspirin and dipyridamole (25 and 200 mg bid), clopidogrel (75 mg/day), or ticlopidine (250 mg bid) may be used. The choice of antiplatelet agent should be individualized and based on comorbidities, sensitivity, cost, and other characteristics.
Level of evidence B.
For VA stenoses in the first segment, both open and endovascular techniques are recommended. In the presence of pathological tortuosity or anomaly of discharge of the PA, open surgery is preferable. In case of VA stenoses in II-IV segments, the use of endovascular techniques is preferable.
Level of evidence C.
In case of stenoses of segment I of the VA, the operation of transposition of the VA mouth into the CCA or RCA is recommended. If these operations are not possible, transsubclavian VA endarterectomy or VA orifice endarterectomy with venous patch isthmoplasty can be performed.
In case of pathological tortuosity of the 1st segment of the VA, the operation of transposition of the VA in the CCA or RCA, the operation of isthmoplasty with the creation of a new orifice of the VA in the RCA, and the modified Powers operation are recommended.

21.10.2018

The blood supply to the brain is provided by two internal carotid arteries, two vertebral arteries.

The carotid arteries (carotid pool) supply 70-80% of the blood to the brain.

The vertebral arteries (vertebrobasilar basin) supply blood to the posterior parts of the brain: the medulla oblongata, cerebellum, and cervical spinal cord. The vertebral arteries from the chest cavity pass (through the bone canal in the transverse processes of the cervical vertebrae) to the brain and supply 15-30% of the blood. Paired jugular veins located in the neck drain blood from the head and neck.

The vertebral and carotid arteries are located in the neck region, supplying blood to the brain, muscles and tissues of the head, neck, and thyroid gland.

Arising narrowing of the vessels of the cervical spine leads to oxygen starvation of the brain, accompanied by various symptoms: dizziness, pain in the back of the head, loss of coordination, visual disturbances.

The causes of narrowing of the vessels of the neck are: congenital and acquired.

Congenital causes include:

• hypoplasia of the cervical vessels;
• congenital stenosis of the arteries of the neck;
• anomalies of the cervical vertebrae;
• vertebral arthrosis (dystrophic changes in cartilage) of the vertebrae of the neck.

For purchased:

• atherosclerosis;
• and hernia and trauma of the cervical spine;
• osteochondrosis of the cervical spine;
• osteophytes - growths on the bone (thorns);
• arterial hypertension;
• diabetes;
• neoplasms of the neck.

There is a congenital pathology of the carotid arteries - hypoplasia (congenital underdevelopment) of the left, right, and occasionally both spinal arteries. This congenital defect can form during the period of intrauterine development of the child. The causes of the anomaly have not been established.

Hypoplasia leads to narrowing of the lumen of the blood vessels with consequences. Anomalies in the development of the fetus, including underdevelopmentvessels in the cervical region, can cause causes: bad habits, chronic intoxication, infectious diseases (flu, rubella), radiation exposure, trauma to a woman during the period of bearing a child.

Risk factors

• atherosclerosis. Elevated cholesterol and lipid metabolism disorders lead to the formation of plaques on the walls of blood vessels;
• diabetes. Helps to reduce the elasticity of arterial vessels and the formation of plaques on their walls;
• arterial hypertension. A constant increase in vascular tone leads to a decrease in their normal diameter;
• excessive mental stress;
• osteochondrosis, injuries, hernias contribute to mechanical compression of the carotid arteries;
• obesity;
• neoplasms in the neck.

The use of fried and fatty foods, stress, sedentary work and an inactive lifestyle, bad habits (alcohol, smoking, drugs) are factors provokingstenosis of the vessels of the neck.

Symptoms of narrowing of the vertebral arteries

Symptoms of the disease appear with age. In youth, the insufficient supply of oxygen to the brain is compensated by the reserves of the body: an increase in pressure, an increase in the blood flow of small (roundabout) vessels (collateral blood flow), and the formation of anastomoses (connections between vessels).

• headache;
• dizziness;
• loss of orientation in space;
• fainting;
• unsteady gait;
• nausea and vomiting.

The vertebral arteries are located in special canals of the cervical vertebrae, so nature anatomically protected them from damage. With the pathology of the cervical spine, deformation of the vessels is possible.

Deformation of blood vessels can be caused by sharp turns, tilting of the head during sports. The left artery is wider than the rightvertebral artery and supplies more blood to the brain. Violations in the left artery are accompanied by vivid symptoms.

Doctors say that the narrowing of the right artery of the spine is fixed. Pronounced symptoms are manifested by hypoplasia of the left cervical artery.

In pathology, in addition to the general symptoms of stenosis, the following are noticeable:

• nosebleeds;
• deterioration in visual acuity;
• hearing loss;
• increased blood pressure;
• deterioration in the sensitivity of the limbs;
• frequent mood swings (changes), emotional instability.

The narrowing of the lumen of the vessels of the neck by 50% leads to serious consequences, such as cerebral stroke and encephalopathy.

Vertebrobasilar insufficiency (VBI) (due to external vascular compression) may occur if a patient has:

• anomalies of the neck muscles;
• adhesions in the neck and shoulder area;
• trauma and displacement of the vertebrae of the neck;
• degenerative-dystrophic lesions of the neck joints;
• venous discirculation (impaired blood outflow);
• additional cervical ribs.

With vertebrobasilar syndrome, the patient experiences: dizziness, impaired vision, speech, tinnitus, in the worst case, a stroke.

A brain stroke is a damage to the brain as a result of a violation or cessation of the blood supply to its individual sections, leading to the death of cells.

Encephalopathy of the brain is a pathology in which there is insufficient supply of blood and oxygen to the brain tissue, nerve cells die. Areas of decay, stagnation of blood and hemorrhages appear, cerebral edema is formed.

In young and middle-aged patients, vasoconstriction occurs due to compression by osteophytes (bone growths) of the vertebral arteries. In older people, the disease provokes atherosclerosis, the appearance of plaques in the arteries..

Diagnosis

Making an accurate diagnosis is problematic due to the similarity of symptoms with other diseases. To make a diagnosis:

• the history of the disease and complaints of the patient are studied;
• do an ultrasound of the heart;
• Doppler ultrasound is performed to assess the usefulness of the blood flow of the head and neck;
• conduct CT and MRI to detect the causes of the disease;
• angiography is done to study the condition of the walls of the arteries, to study the diameter of the vessels;
• radiography with a contrast agent to study the condition of the arteries of the spine, the degree of their damage.

After examining and assessing the patient's condition, the doctor selects the necessary diagnostic methods.

Treatment of stenosis

Disease vessels in the neck established at an early stage. By optimizing nutrition, getting rid of bad habits, avoiding harmful factors, you can stop the development of the disease and eliminate its symptoms.

For medical treatment, use:

• anti-inflammatory drugs (Ibuprofen, Nurofen, Voltaren);
• antioxidants - vitamins A, E, C, group B, trace elements;
• vasodilators - Actovegin, Cavinton;
• simvastatins, which lower blood cholesterol levels (Levomir, Actalipid);
• neurotrophic drugs (Cerebrolysin, Nootropil);
• antihypertensive drugs;
• antidepressants (amitriptyline).

If the vasoconstriction reaches 70%, then the pathology has to be treated by one of the methods:

• carotid endarterectomy - scraping off the walls of the plaques, restoring the lumen of the vessel;

• angioplasty - expansion of the lumen by installing a catheter;
• angioplasty - straightening the narrowed area with a wire frame.

These methods have their own advantages and disadvantages. Choose a method taking into account contraindications after examining the patient.

Prevention

At in the treatment of stenosis, breathing exercises are useful for patients of age categories. Performing breathing exercises saturate the blood with oxygen, relieve signs of fatigue and fatigue. Complexes of physiotherapy exercises are useful.

• sea ​​fish of low-fat varieties;
• legumes;
• greens and fresh vegetables;
• fruit.
• dairy products;
• coarse grains.

It is useful to drink green or herbal tea. It is necessary to follow a diet with the use of salt, excluding fried, fatty, spicy, smoked foods.

Exclude sweets and stimulants from the menu (coffee, cocoa, chocolate, strong tea). Avoid eating foods high in cholesterol. Fatty meat, margarine, spread, animal fats bring harm to the body.

Consult a doctor at the first symptoms of the disease. The advanced stage of the disease leads to irreversible consequences.

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Vertebral artery stenosis is a disease that can be either congenital or acquired. The most frequent and formidable complications in this case are coronary heart disease and stroke. And the complexity of the treatment of such a pathology is that at the initial stages there are almost no symptoms at all.

The term itself means nothing more than a blockage, blockage or vasoconstriction. As a result, there is a violation of blood flow, as a result of which the brain receives an insufficient volume of blood for it, which means oxygen and nutrients. The first signs begin to appear when the narrowing of the artery reaches 50%, and even with a shortage of 40% of the total blood supply, chronic insufficiency occurs, which manifests itself with the following symptoms:

1. Headaches, accompanied by dizziness, loss of visual acuity and clarity. Moreover, the pain syndrome can not be removed with analgesics or other drugs.
2. Pain in the lower back. This is one of the main symptoms of spinal vasoconstriction. The intensity becomes maximum when walking, during the period of physical activity, and the pain does not disappear even at rest. A posture in which the back is tilted forward helps to reduce it.
3. Numbness of the extremities, which manifests itself in restless legs syndrome, muscle weakness, tingling. Most often, such manifestations disappear after a change in body position.
4. High blood pressure is an attempt by the body to compensate for the lack of blood flow to the brain.

All these manifestations mean that pathological changes in the vessels have reached a life-threatening stage for the patient.

The reasons

Stenosis of the vertebral arteries does not occur without a cause. Three reasons are known for its development today. In the first case, this is a congenital factor, that is, a genetic predisposition that leads to any congenital disorders in the structure of the vessel. If the progression of the disease does not occur, then people with such pathologies can live for many years without limiting themselves in anything.

The second reason is the acquired factor. This is the very reason that requires mandatory treatment. Provoke blockage can, diabetes, metabolic disorders.

And finally, the third factor is traumatic. The narrowing of the artery can occur due to a fracture, bruise, if a hematoma occurs. In this case, surgical treatment is mandatory.

How dangerous

In the presence of symptoms, the prognosis of vertebral artery stenosis is extremely unfavorable. A progressive form is always a reason for disability. But the treatment will completely depend on where exactly the pathology is localized.

The ostium form is always emotional disturbances, which can be expressed in panic attacks, photophobia. The main treatment is surgical, before surgery, drug therapy is required.

Subcompensated form occurs as a complication of traumatic injury. Medical treatment is not possible, only surgery is needed. Another fairly common cause is cancer. In this case, most often the patient dies literally within a year.

Vertebrogenic stenosis is also characterized in the sacrum. At the same time, no inflammatory processes can be identified.

The compensated form proceeds slowly, there are no signs of an acute onset, there is no need for urgent surgical treatment.

Intracranial stenosis occurs with arterial thrombosis and is usually fatal.

Stenosis of extravasal compression on the left is a consequence of diseases of the spine. The cause may be osteochondrosis, hernia, oncology. After the causes are eliminated, the blood supply most often resumes in a normal volume.

Stenosis of extravasal compression on the right has the same causes as the previous version.

The dynamic type is accompanied by complete or partial vascular occlusion. This is the most life-threatening condition. Medicines can only help to overcome the symptoms themselves, but it is possible to cure the pathology only with the help of surgery.

A functional symptom begins to manifest itself only in one or another position of the neck. The basis of the disease is osteochondrosis and other disorders.

Multifocal stenoses have numerous causes. The only way out is angioplasty with the replacement of a section of the damaged artery.

Hemodynamically significant stenosis is observed when the vessel narrows by more than 50%.

The decompensated form is one of the most severe, when vasoconstriction is completely irreversible. The only way out is to completely replace the affected area or create a bypass channel for blood flow.

Treatment of vertebral artery stenosis begins after diagnosis and determination of the type of disease. The most commonly used surgery, drug treatment is used extremely rarely.

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Circulatory disorders can be triggered by various factors: from damage to the blood vessel itself to developmental anomalies. Therefore, further we will analyze in detail the features of the occurrence and treatment of the syndrome of narrowing of the vertebral artery.

Stenosis of the cervical vertebral artery- a pathological phenomenon in which there is a narrowing or blockage of the vascular lumen.

Diagnosis of pathology is complicated by the fact that at the initial stages of its development, symptoms are practically absent.

Reference. Characteristic signs of stenosis appear in the case of narrowing of the vessel by more than 50-55%.

Both the narrowing of the left vertebral artery and the right one can develop. There are cases when stenosis affects both vessels at once.

The disease is serious because it can lead to disability and death of the patient. Therefore, in order to avoid consequences, treatment should be started immediately.

Symptoms and Diagnosis

Symptoms will not depend on whether the narrowing of the left vertebral artery or the right one has occurred. The overall clinical picture in both cases consists of the following manifestations:

Severe headache is a characteristic symptom of pathology

• headache- severe attacks of pain (painkillers are not stopped) may be accompanied by a deterioration in vision, the appearance of "flies" before the eyes, dizziness;
• limb numbness- may be accompanied by a feeling of cold, "goosebumps", muscle weakness, tingling. Discomfort disappears after a change in body position or a small warm-up;
• increase in blood pressure- develops due to the body's attempts to normalize blood flow;
• pain in the lower back- becomes more intense with physical exertion, and soreness does not go away after rest. The feeling of discomfort is reduced only when the back is tilted forward.

There may also be additional manifestations: hearing impairment, nosebleeds, nausea and vomiting, frequent mood swings.

The symptoms and treatment of vertebral artery stenosis are interconnected, because the therapeutic tactics will depend on the nature and characteristics of the pathological process.

Therefore, the patient undergoes a thorough examination, during which the following diagnostic methods are used:

The patient is examined

1. Assessing the condition, collecting an anamnesis.
2. Ultrasound of the heart.
3. Angiography - allows you to assess the condition of the vascular walls and examine their diameter.
4. Doppler ultrasound - to determine the characteristics of blood flow.
5. Radiography - used to determine the condition of the vessels and the degree of their stenosis.
6. CT, MRI - to identify the causes of pathology.

Based on the results of the examination, the specialist selects a treatment regimen, focusing on the features of the lesion, age and individual characteristics of the patient.

The development of the disease can occur under the influence of various negative factors.

In medicine, the causes of narrowing of the vertebral artery are classified into several groups:

Mainly provoked by diseases and anomalies in the development of blood vessels

• congenital- hereditary predisposition can lead to. If the pathology does not develop, then people lead a full-fledged lifestyle;
• acquired- atherosclerosis, metabolic disorders, diabetes mellitus. Require mandatory therapy;
• traumatic- a bruise with the formation of a hematoma,. With a weak regenerative process, the lumen narrows up to complete blockage.

To the risk group include people whose professional activities are associated with excessive mental stress, athletes (lack of blood supply with hypertonicity of the scalene muscles), as well as people suffering from obesity, arterial hypertension.

Treatment

How to treat narrowing of the right vertebral artery? Therapy of the disease is carried out taking into account the cause of the development of a pathological disease, its variety and nature of the course.

Reference. Mainly used medical and surgical therapeutic technique.

In drug therapy, the following types of drugs are used:

1. NSAIDs- Voltaren.
2. Antidepressants- Amitriptyline.
3. Neurotrophic agents- Cerebrolysin, Nootropil.
4. Vascular drugs- Actovegin, Cavinton.
5. Simvastatins- Actalipid.
6. Antioxidants- complexes of vitamins and microelements.

Various groups of medicines are used

It is used in cases where the disease is caused by trauma or when 70% stenosis is reached.

The operation can be performed by one of the surgical techniques:

• carotid endarterectomy- removal of cholesterol plaques and restoration of the vascular lumen;
• endarterectomy- removal of the affected vascular area with further installation of the implant;
• angioplasty- expansion of the lumen with a catheter or wire frame.

The choice of surgical technique depends on the cause of the disease, and the existing contraindications are also taken into account.

Folk methods

Can be used as a preventative

Treatment of vertebral artery stenosis with folk remedies today is not able to eliminate the problem.

Various decoctions, tinctures based on medicinal plants help strengthen the vascular walls, normalize their tone, regulate blood pressure, and normalize blood circulation.

But they cannot affect already narrowed vessels and restore their lumen.

That's why it is advisable to use folk remedies for this disease as a preventive measure.

Prevention

There are no specific preventive measures for this pathological phenomenon, however the following guidelines should be followed:

Need to lead a healthy lifestyle

• avoid injury;
• do not overstrain mentally and physically;
• perform breathing exercises;
• do physical education;
• eat properly and nutritiously;
• exclude the use of alcoholic beverages.

Also should visit a doctor when the first symptoms occur to ensure timely treatment and prevention of dangerous consequences.

Conclusion

Violation of blood circulation in any manifestations is a dangerous condition, since the blood in the human body is a kind of transport for the delivery of nutrients and oxygen to tissues and organs.

Without this function, hypoxia and tissue cell death can develop. Therefore, the occurrence of characteristic symptoms should prompt a person to immediately visit a doctor.

Stenosis of the vertebral artery is a condition in which there is a compression of the main vessel and a violation of blood flow in it.

Against the background of the development of the disease, there is a deterioration in cerebral blood supply and the occurrence of various disorders. This is due to the fact that the vertebral arteries, together with the carotid arteries, serve as the main channels supplying blood to the organs of the neck and head. As a result of vasoconstriction, the nutrition of individual parts of the brain decreases and reversible violations of its functions take place. Poor supply of oxygen and substances leads to hypoxia of nerve cells, a complication of which is ischemic stroke. From this we can conclude that pathology poses a threat to human health and life, therefore, it needs timely and adequate treatment. If therapy is carried out at the stage when the vessel narrows only by half, then the prognosis will be favorable.

Stenosis of the vertebral artery, which is scientifically called vertebrobasilar syndrome- this is a congenital or acquired disease, a variety of factors can provoke it. Consider the main causes of the development of pathology, its symptoms and ways to correct the condition.

Etiology

The narrowing of the lumen of the main artery, as a rule, is a consequence of degenerative processes in the joints or vertebral discs surrounding the vessel.

The most susceptible to pathological changes are the lumbar and cervical regions. If the stenosis is of a congenital nature, then in its etiology there are deviations in the structure of the spine. Acquired disease progresses against the background of unfavorable the influence of various factors.

According to the nature of origin, they distinguish functional and organic stenosis. The first is the result of degenerative-dystrophic changes, such as Bechterew's disease, spondylosis, osteochondrosis. Such ailments lead to deformation and displacement of the vertebrae and the cessation of blood microcirculation.

In cases where there is instability of the elements of the cervical region, there is insufficiency of both vertebral vessels.

The cause of the progression of organic stenosis is atherosclerosis - a vascular disease characterized by the deposition of cholesterol plaques on the walls of the vertebral arteries. The formed fat and fibrous particles gradually increase in size and block the blood flow. Also provoking factors of this type of stenosis are tumors in the transverse processes of the vertebrae, osteophytes of small vertebral joints, and hypertonicity of the surrounding muscles.

Symptoms

How does vertebral artery stenosis manifest itself? The main signs of pathology are the following violations:

• visual disorders- ripples and flies before the eyes, photopsy, blurring, dark spots in the fields of vision;
• ataxia- inability to maintain the balance of the body, associated with a violation of the functionality of the cerebellum, poorly nourished by blood;
• vestibular disorders- frequent dizziness, inadequate reaction to bright light, involuntary oscillatory eye movements.

Diagnostics

To determine the presence of stenosis of the vertebral artery, the doctor relies on
the patient's medical history (existing symptoms of impaired vertebrobasilar insufficiency) and the results of the study. In the diagnosis of pathology, the following methods are used:

1. Doppler ultrasound of the neck vessels.
2. Angiography.
3. CT scan.
4. Magnetic resonance angiography.
5. Radiography.

Conducting a comprehensive study allows not only to determine the narrowing and its localization, but also to find out the causes of the pathological condition.

Treatment tactics

The choice of method of therapy depends on the type of stenosis and the degree of narrowing of the vertebral artery.

With a functional disease, conservative treatment is used, in particular drugs that reduce blood pressure. Also, when the vessels in the cervical spine are compressed, orthopedic correctors are used to limit the mobility of the vertebrae and prevent their mechanical effect on the vessels.

With an exacerbation of the pathology, drugs are prescribed that regulate the process of blood coagulation or surgical angiocorrection. Pharmacological agents of the neurotrophic group and antioxidants are effective in the treatment of stenosis. If necessary, blood circulation in the artery is normalized using surgical techniques.