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Vertebrobasilar Insufficiency

Authors:
  • Amy Scholten, MPH
Publication Type:

Condition

Vertebrobasilar Insufficiency

Definition

Vertebrobasilar insufficiency is poor blood flow to the back of the brain. This is due to damaged blood vessels (arteries). Blood flow to the back of the brain is supplied by two arteries of the neck. These two arteries join to form the basilar artery.

A decrease in blood flow can harm the brain and impair normal function.

Causes

Vertebrobasilar insufficiency is caused by a narrowing or damage of the arteries. The most common cause is atherosclerosis, a build-up of plaque in blood vessels. Plaque is a fatty substance in the blood.

Plaque buildup makes it hard for blood to flow through the blood vessels. In time, it can fully block the artery.

The blood vessels may also be damaged due to a problem that a person was born with.

Risk Factors

Things that can raise the risk of vertebrobasilar insufficiency are:

Symptoms

A person with vertebrobasilar insufficiency may have:

  • Vision problems
  • Headache
  • Lightheadedness or vertigo—a feeling of spinning while standing still
  • Loss of coordination
  • Numbness or tingling, often in arms
  • Nausea or vomiting
  • Problems speaking
  • Sudden weakness

Diagnosis

The doctor will ask about symptoms and health history. A blood flow problem in the brain may be suspected based on symptoms.

Tests are done to confirm vertebrobasilar insufficiency. Images of the blood vessels in the brain may be taken with:

An x-ray angiography may be done if the imaging tests are not clear. This can help the doctor see how much of the blood vessel is blocked. An MRI scan may also be done to see if a stroke has happened.

MRI of the Brain.

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Treatment

The goals of treatment are to reduce harm to the blood vessels and lower the risk of stroke. Ways to do this are:

Prevention

Heart healthy habits can help keep blood vessels healthy. They include:

  • Working out regularly.
  • Eating more fruits, vegetables, fish, and whole grains. Limiting dietary salt and fat.
  • Quitting smoking.
  • Drinking alcohol only in moderation. This means no more than 2 drinks per day for men and 1 drink per day for women.
  • Keeping a healthy weight.
  • Managing long term health problems such as high cholesterol, blood pressure, and diabetes.
  • Getting help for alcohol use disorder or drug abuse.

Improving Heart Health

If the vertebrobasilar insufficiency and its symptoms are not severe, the doctor may advise:

  • Lifestyle changes—such as healthy diet, regular work outs, and quitting smoking
  • Medicines to:
    • Lower blood pressure
    • Reduce cholesterol
    • Lower the risk of blood clots and stroke

Improving Heart Health

If the vertebrobasilar insufficiency and its symptoms are not severe, the doctor may advise:

  • Lifestyle changes—such as healthy diet, regular work outs, and quitting smoking
  • Medicines to:
    • Lower blood pressure
    • Reduce cholesterol
    • Lower the risk of blood clots and stroke

Surgical Options

A procedure may be needed if there is more severe blockage or damage. The doctor may advise:

  • Angioplasty—a balloon is placed in the blood vessel to widen it
  • Stents—a device is placed in the blood vessel to keep it open
  • Open surgery is a rare option, such as:
    • Endarterectomy—removes plaque build-up on the inside of the blood vessel
    • Bypass—A healthy piece of blood vessel is attached near the blockage to re-route blood flow
RESOURCES:

CANADIAN RESOURCES:

CANADIAN RESOURCES:

References

  • Lima Neto, A.C., Bittar, R., et al. Pathophysiology and diagnosis of vertebrobasilar insufficiency: a review of the literature. Int Arch Otorhinolaryngol, 2017; 21 (3): 302-307.
  • Vertebral artery stenosis and occlusion. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/vertebral-artery-stenosis-and-occlusion.
  • Vertebral basilar insufficiency. Nebraska Medicine website. Available at: https://www.nebraskamed.com/neurosurgery/vertebral-basilar-insufficiency.
  • Vertebrobasilar insufficiency. UC Davis Health System website. Available at: https://health.ucdavis.edu/vascular/diseases/vertebrobasilar.html.

Contributors

  • Michael J. Fucci, DO, FACC
Last Updated:
2022-09-01

(C) Copyright 2022 EBSCO Information Services

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.