1Possible consequences of vertebral artery stenosis and narrowing treatment
- 1.1What is spinal stenosis?
- 1.2How dangerous is the disease
- 1.3What methods are used to treat the disease?
- 1.4Which diet is optimal for treatment
2Stenosis of the vertebral artery: left, right, what it is, symptoms
- 2.1The essence of pathology
- 2.2Causes of stenosis
- 2.3Diagnosis of cerebral blood flow insufficiency
- 2.4Treatment of the disease
- 2.5Prognosis of PA stenosis
3Symptoms and treatment of vertebral artery stenosis
- 3.2How dangerous
4Narrowing of the vertebral artery: right, left | Second opinion
- 4.1Radiography with narrowing of the lumen of the vertebral artery: right or left
- 4.2Why does the narrowing of the vertebral artery develop?
- 4.3Narrowing of the left vertebral artery: symptoms
- 4.4Principles of treatment of vertebral artery syndrome
- 4.5Methods for detecting compression of vertebral vessels (right and left)
5Narrowing of vertebral arteries
- 5.1Symptoms of narrowing of the vertebral artery
- 5.2Treatment of narrowing of the vertebral artery
6symptoms, treatment and microbial 10
- 6.1Causes of the disease
Possible consequences of vertebral artery stenosis and narrowing treatment
Congenital or acquired stenosis of the vertebral artery is a pathological disorder leading to ischemic disease and cerebral stroke.
The complexity of therapy consists in the fact that in the early stages of the disease there is practically no symptomatology. Medicamental treatment brings relief only in 30-40% of cases.
The positive effect of prescribing is temporary. Complete recovery is possible only after a surgical procedure.
What is spinal stenosis?
Literally, the term stenosis refers to occlusion, blockage, or narrowing of blood vessels. As a result of disturbances, the course of blood flow becomes difficult, the intensity of brain supply with nutrients and oxygen decreases.
Signs of stenosis of the canal of the left vertebral artery begin to appear after the internal cavity of the vessel narrows more than 50%.
Since the vertebral artery provides about 35-40% of the entire blood supply to the brain, chronic insufficiency occurs, which is evidenced by characteristic symptoms:
- Headaches - migrenoznye crises are accompanied by dizziness, a decrease in the clarity of vision. Pain syndrome is not removed with the help of conventional analgesics.
- Back pain is one of the first symptoms of stenosis of the spinal vessels. Intensity is exacerbated during walking, physical activity. The pain does not pass when stopped and at rest. Reduction of pain is observed when the back is tilted forward.
- Numbness of the extremities. With the development of pathology and the continuation of the narrowing of the distal part, there is restless leg syndrome (sensation of goosebumps), muscle weakness, tingling. Usually discomfort occurs when the body position changes, especially when tilting forward.
- Increase in blood pressure - occurs due to independent attempts of the body to ensure normal blood supply to the brain. With prolonged hypertension, the symptoms characteristic of hypertension are observed: decreased visual acuity, movement coordination disorders, etc.
The appearance of clinical manifestations indicates that pathological changes have become a form that is life-threatening to the patient.
There are three main causes of stenosis of the vertebral artery:
- Congenital factor - genetic predisposition leads to congenital disorders in the structure of blood vessels. If there is no progression of the disease, with such a stenosis live a full life, with almost no restrictions.
- The acquired factor is one of the main reasons for the treatment of vertebral artery stenosis. Vascular obstruction may be triggered by atherosclerosis, diabetes and metabolic disorders.
- Traumatic factor. Narrowing of the artery occurs due to a bruise, fracture, the appearance of bruising in the place of trauma. Mandatory surgical treatment is prescribed in order to eliminate the causes of blockage of the artery.
How dangerous is the disease
The prognosis of the disease is extremely unfavorable and mainly depends on the localization of pathological changes. Critical stenosis of the right vertebral artery leads to a stroke, a possible fatal outcome. Progressive form of the disease, this is a criterion for disability.
Regardless of whether surgical treatment was performed, the patient is placed on the disability group in the late stages of stenosis. Disability can be prescribed taking into account the consequences of stenosis (stroke, it.d.
) The methods of therapy of the disease and the consequences of stenosis largely depend on its localization.
- Priustevoy stenosis - characterized by severe emotional disorders: attacks of panic fear of death, frontal pressing pain and associated irritability, photophobia. Depending on the causes of pathological changes, it is recommended to perform surgical intervention, drug therapy in the pre-operative period.
- Subcompensated stenosis - mainly occurs as a result of a traumatic factor. Cure with medication is impossible, surgical correction is necessary. Another common cause of development is cancer. In this case, the pathology often ends in a lethal outcome.
- Vertebrogenic stenosis - characteristic signs are pain syndrome in the lower back and the area of the sacral department. Stenosis is not accompanied by inflammatory processes. On MRI there are signs of moderate atrophy of the frontal lobe of the cerebral cortex.
- Compensated stenosis - the development of pathology is slow, there are no signs of an acute form of the disease. As a consequence, there is no need for urgent surgical intervention.
- Stenosis of the intracranial region - accompanied by thrombosis of the artery. In an unfavorable confluence of circumstances, the disease progresses rapidly and a stroke occurs.
- Stenosis of extravasal compression of the left vertebral artery - develops due to abnormal diseases of the spine. The cause of development can be osteochondrosis of the cervical region, a hernia, an oncological neoplasm and other pathologies. After eliminating the causes of the development of the disease, blood supply, as a rule, is restored.
- Stenosis of extravasal compression of the right vertebral artery - for this diagnosis the etiology and causes of development are identical to the narrowing of the observed on the left side of the spine.
- Dynamic stenosis - accompanied by a complete or partial occlusion of the vessel. It is extremely dangerous for the life of the patient. Drug therapy removes only the symptoms and is mainly used to prepare the patient for surgical intervention.
- Functional stenosis - symptomatic arises only at a certain position of the neck. The development of the disease occurs only against the background of osteochondrosis, spondylosis and other disorders of the spine structure.
- Multifocal stenoses - multiple vascular lesions. Surgery is ineffective. Appointed drug therapy, and if it is ineffective, angioplasty with a complete replacement of damaged parts of the arteries
- Hemodynamically significant stenosis is a condition in which a narrowing of the vessels is more than 50%. As a result, a condition appears that affects the normal blood flow and, accordingly, the activity of the brain.
- Decompensated stenosis is one of the most difficult conditions. The narrowing of the lumen of the vessels takes on a chronic form and becomes irreversible. The only possible solution, a complete replacement of the damaged section of the artery or the creation of a duplicate channel.
Before the appointment of therapy methods, it is mandatory to conduct differential diagnosis, to determine the exact cause of the development of disorders, the degree of development and the form of the disease. Classification of the degree of stenosis plays an important role in determining the appropriateness of the appointment of a surgical operation.
What methods are used to treat the disease?
There are three main areas of therapy for stenosis of the vertebral column.
- Drug therapy - prescribe vascular drugs that promote the development of elasticity and strength, drugs to control blood pressure, diluting blood and helping to reduce thrombogenesis. Simultaneously, the complex therapy uses therapeutic physical training, manual therapy and hirudotherapy.
- Operative intervention - surgical correction is performed to eliminate complications after injuries and disorders in the structure of the spine. Stenosis is also treated with stenting. A metal frame is inserted into the artery, which prevents rupture and further narrowing of the vessel. The duration of the operation of the stents is about 15 years. To reduce the probability of rejection, the steel frame is covered with plastic.
- Traditional methods of treatment. The method is still not recognized by official medicine. Medicinal tinctures and broths help to normalize the tone of blood vessels, restore normal blood supply and normalize blood pressure. As an evidence of stenosis prevention, an effective method of therapy is sufficient.
To assign the optimal type of therapy, the attending physician sends to several diagnostic procedures.
One of the most informative ways to get a complete picture of pathological changes is duplex scanning of the arteries. In addition, an MRI of stenosis may be required.
Ultimately, the decision, rather than treat, depends on the patient himself. If the patient has constant dizziness, chronic shortage of air, narrowing of blood vessels more than 70%, are absolute indications for the surgical operation.
Which diet is optimal for treatment
Therapeutic diet is aimed at overcoming the causes of development of narrowing of the arteries. Specially designed diet does not exist.
Patients are recommended to use one of the diets designed to combat cardiovascular pathologies. From the diet will need to be excluded: fatty and high-calorie foods, sweet, floury.
Instead, you should consume as much as possible fish (any variety), fruits and vegetables. Caution should be given to drinking alcohol, coffee and tea.
It was noted that losing only a few kilograms of weight reduces the risk of rapid development of stenosis due to atherosclerosis. Therapeutic gymnastics is one of the best ways to normalize a patient's weight.
Although recently there have been many developments aimed at overcoming stenosis, so far The only way to combat a disease that is highly effective is the surgical operation.
A source: http://ponchikov.net/health/serdce-sosudy/504-stenoz-pozvonochnoy-arterii.html
Stenosis of the vertebral artery: left, right, what it is, symptoms
Stenosis of the vertebral artery is a narrowing of the artery, resulting in impaired blood circulation in the brain, there is a deficiency of nutrients, oxygen starvation of nerve cells (neurons) and ischemic stroke.Vertebral arteries (PA) are one of the main vessels running along both sides of the spine (the left and right arteries) and supplying the brain with blood (up to 25% of the total volume of blood entering the head).
The essence of pathology
Chronic failure occurs when there is a shortage of 35-40% of the blood and is characterized by the following symptoms:
- dizziness, migraines, which are not affected by analgesics;
- deterioration of vision - the phenomenon of flies, dark spots or visual images before the eyes;
- deterioration of memory and intellectual abilities;
- violation of coordination of movements due to damage to the cerebellum;
- lumbar pain, worsening when walking and exercising, subsiding when tilted forward;
- feeling of numbness of the limbs, tingling and "goose bumps" in the legs, weakness in the muscles;
- arterial hypertension;
- pain in the cervico-occipital region.
If the vertebral artery is narrowed in half, the patient's condition worsens, sudden fits of loss of consciousness and circulatory failure become frequent, in which part of the brain cells die.
Causes of stenosis
By the factors provoking the development of stenosis, three main groups are classified:
- Hereditary pathologies associated with blood vessels. In the absence of exacerbation, the disease does not manifest itself and the person remains active throughout life.
- Stenosis, acquired as a result of diseases affecting the circulation (atherosclerosis, diabetes and metabolic disorders).
- Narrowing of the walls of the arteries due to the injury (bruise, fracture, bruises).
The causes of stenosis:
- diseases that cause degeneration and dystrophy of the vertebral columns of the cervical spine (osteochondrosis, spondylosis, Bekhterev's diseases), which led to the mixing of vertebrae and impaired microcirculation of the brain;
- atherosclerosis of blood vessels due to the concentration of cholesterol plaques in the vascular cavity;
- tumors of vertebral appendages;
- bone growths (osteophytes) in the joints of the intervertebral space;
- hypertonus and spasms of the cervical and stair muscles.
Depending on the lesions, the following types of PA stenosis are distinguished:
- Priustevoy stenosis is a form of lesion of vertebral arteries on the right or on the left, accompanied by mental disorders, which are manifested in outbreaks of panic attacks, fear of death, compression pain in the frontal part, irritability and fear Sveta. The main treatment is surgical.
- Subcompensated stenosis is provoked by the resulting injuries and the resulting displacements in the cervical spine. Surgery is necessary to correct posttraumatic complications. If the lesion is caused by an oncological tumor, then the disease ends lethal.
- Vertebrogenic stenosis - characterized by the manifestation of pain in the lumbar and sacral areas of the spine without any inflammation processes and moderate changes in the frontal lobe of the cerebral cortex. Vertebral vessel is examined by means of MRI. Treatment operatively by stenting through the puncture of the femoral artery and the installation of an edentulous prosthesis.
- Compensated stenosis - is characterized by a slow course of the disease, when the lumen of the walls of the vessels narrows gradually and makes it possible to treat the ailment medically, without surgery.
- Stenosis of the intracranial region - causes thrombosis of the artery, rapidly progresses and provokes a stroke.
- Narrowing of the left vertebral artery - is a consequence of abnormal changes in the spine (cervical osteochondrosis, intervertebral hernias, cancerous tumors). The prognosis with complete elimination of the sources of the development of the disease is favorable, the blood supply of the brain tissues is restored.
- Stenosis of the right vertebral artery - symptoms and treatment are similar to stenosis in the left side of the spine.
- Dynamic narrowing of PA - is expressed in complete or partial violation of the patency of arteries and is considered the most dangerous type of stenosis. Treatment with drugs is only symptomatic, emergency surgical care is required.
- Functional stenosis - manifests only at a certain position of the neck, progressing due to the existing osteochondrosis, spondylosis and other spinal lesions.
- Multifocal stenoses are lesions of several or multiple vessels. Apply only drug therapy or angioplasty, which involves replacing affected tissues of the arteries.
- Hemodynamic narrowing of the vessels means that the obstruction affects more than half of the vessel, in which the vital activity of the brain is disturbed.
- Decompensated stenosis - the disease becomes chronic, the process becomes irreversible. The prognosis is relatively favorable when the arterial jug is completely replaced or an alternative blood flow channel is created.
- Stenosis of the spinal canal due to its narrowing. This type of stenosis is observed in the lumbar region and causes squeezing of the nerve roots of the lumbar plexus and neuralgia of the sciatic nerve. Can be observed in the cervical spinal cord, squeezing the last, which can lead to complete paralysis.
Diagnosis of cerebral blood flow insufficiency
To study the blood circulation of the brain, the following instrumental methods are used:
- dopplerogramma vessels of the cervical spine to identify the processes of narrowing of the arteries;
- angiography - the introduction of contrast agents in the vessels and their radiographs to exclude atherosclerotic and anatomical disorders of the vascular system;
- magnetic resonance angiography - scanning of contrasting arteries;
- CT using a contrast solution administered to the artery to determine the degree of stenosis;
- Contrasting panangiography - X-ray diffraction using contrast agents, which allows to detect the presence and location of thrombus for surgery.
Treatment of the disease
Narrowing of the vertebral artery is a disease in which timely treatment is necessary, otherwise complications can lead to ischemic stroke. Treatment of stenosis is appointed based on the causes that caused pathological processes, and the type of stenosis.
Drug therapy provides for the effects on the symptoms of an illness, suppressing their manifestation: drugs that lower blood pressure are used (Indap, Lozap, Dibazol,
); Orthopedic collars, limiting mobility of cervical vertebrae; anticoagulants; means for the normalization of blood circulation (Cinnarizine, Mildronate, Encephabol, Vazobral, Instenon, etc.); NSAIDs.
However, drug treatment is effective only in 30-40% of cases, and there is a danger of regression of the disease.
Surgical intervention involves various types of operations depending on the course and localization of the process of narrowing the walls of blood vessels. Among them:
- Endarterectomy - resection of damaged artery sites and the implant (stent).
- Reconstructive operations - arteriolysis, resection and redression of damaged PA departments.
- Stabilization of movement of the mobile part of the spine.
- Removal of osteophytes - bony outgrowths in the intervertebral joints.
- Stenting is the insertion into the channel of the artery of a metal frame lined with plastic, which protects the walls of the vessel from constriction.
- Fixation of the cervical spine when certain articular elements are removed by installing special titanium systems.
Prognosis of PA stenosis
The prognosis of the disease in the predominant majority of cases is quite unfavorable, the outcome is influenced by the location of degenerative changes in PA.
Critical stenosis of the right PA, as a rule, ends in a stroke with a possible fatal outcome.
Patients who have suffered this disease are given a disability.
A source: https://krov.expert/zabolevaniya/stenoz-pozvonochnoj-arterii.html
Symptoms and treatment of vertebral artery stenosis
Stenosis of the vertebral artery is a disease that can be both congenital and acquired.
The most frequent and formidable complications in this case - ischemic heart disease and stroke.
And the complexity of treating such a pathology is that at the initial stages almost completely absent any symptoms.
The term itself means nothing more than blockage, blockage, or narrowing of the vessels.
As a result, there is a violation of blood flow, resulting in the brain is not enough for him the volume of blood, and hence - oxygen and nutrients.
The first signs begin to appear when the narrowing of the artery reaches already 50%, and in fact already at 40% of the total blood supply occurs chronic insufficiency, which is manifested by such symptoms:
- Headaches accompanied by dizziness, sharpness and sharpness of vision. And pain syndrome can not be removed with analgesics or other drugs.
- Pain in the lower back. This is one of the main symptoms of the narrowing of the vessels of the spine. Intensity becomes the maximum when walking, during the period of physical activity, and the pain does not disappear even in a state of rest. To reduce it helps the pose, in which the back is tilted forward.
- Numbness of the extremities, which manifests itself in the restless leg syndrome, muscle weakness, tingling. Most often, these manifestations occur after a change in the position of the body.
- Elevated blood pressure, as an attempt by the body to compensate for the lack of blood flow to the brain.
All these manifestations mean that the pathological changes in the vessels have reached a life-threatening stage for the patient.
Stenosis of vertebral arteries does not occur without a cause. For its development to date, there are three reasons.
In the first case, it is an innate factor, that is, a genetic predisposition, which leads to any inborn violations in the structure of the vessel.
If the progression of the disease does not occur, then with such pathologies, people can live for many years without limiting themselves in anything.
The second reason is the acquired factor. This is the very reason that requires compulsory treatment. Provoke blockage can atherosclerosis, diabetes, metabolic disorders.
And, finally, the third factor is traumatic. Narrowing of the artery can occur due to fracture, bruise, when a hematoma occurs. In this case, surgical treatment is mandatory.
In the presence of symptoms, the prognosis of stenosis of the vertebral artery is extremely unfavorable. Progressive form is always an occasion for disability. But the treatment will completely depend on where the pathology is localized.
Priustevaya form is always emotional disturbances, which can be expressed in panic attacks, photophobia. The main treatment is surgical, medication is mandatory before the operation.
The subcompensated form appears as a complication of traumatic injury. Drug treatment is impossible, only surgery is needed. Another fairly common cause is oncology. In this case, most often the patient dies literally within a year.
Vertebrogenic stenosis is characterized by pain in the lower back and in the sacrum. At the same time, it is impossible to identify any inflammatory processes.
The compensated form proceeds slowly, there are no signs of an acute onset, there is no need for urgent surgical treatment.
Stenosis of the intracranial region proceeds with thrombosis of the arteries and usually leads to a fatal outcome.
Stenosis of extravasal compression on the left is a consequence of diseases of the spine. The cause may be osteochondrosis, hernia, oncology. After eliminating the causes, the blood supply usually resumes in normal volume.
Stenosis of extravasal compression on the right has the same reasons as the previous version.
The dynamic type is accompanied by a complete or partial occlusion of the vessels. This is the most life-threatening condition. Medications can help overcome only the symptoms themselves, but the pathology can be cured only through surgery.
The functional symptom begins to manifest itself only in this or that position of the neck. At the heart of the disease - spondylosis, osteochondrosis and other disorders.
Multifocal stenosis has numerous causes. The only way out is angioplasty with the replacement of the site of the damaged artery.
Hemodynamically significant stenosis is observed when the vessel is narrowed by more than 50%.
The decompensated form is one of the heaviest when the narrowing of the vessels is completely irreversible. The only way out is to completely replace the affected area or create a bypass channel for the blood flow.
Treatment of stenosis of the vertebral artery begins after diagnosis and determination of the type of disease. Surgery is most often used, and medication is rarely used.
A source: https://vashaspina.ru/simptomy-i-lechenie-stenoza-pozvonochnoj-arterii/
Narrowing of the vertebral artery: right, left | Second opinion
Stenosis (constriction) of the vertebral artery (left or right) leads to severe brain symptoms: severe pain in the left and right half of the head, loss of consciousness, convulsions. With right stenosis, the pain syndrome is localized on the right, with the left one on the opposite side.
With early diagnosis of vertebral compression, proper treatment, irreversible changes in brain tissues are prevented.
Through this vessel blood flows to the tissues of the brain.
About 20% of the structures are fed by blood supply from the vertebral arteries to the right and left, passing through the holes of the transverse processes of the vertebrae of the neck.
MRI of the cervical spine in a patient with vertebrob basilar insufficiency
Radiography with narrowing of the lumen of the vertebral artery: right or left
Traditional radiography when narrowing the lumen of the vertebral arteries (right or left) does not show pathological manifestations. On the photo, neuropathologists send patients with certain clinical symptoms:
1. Dyspeptic phenomena (vomiting, nausea); 2. Painful cider of the cervico-occipital part; 3. Peripheral soreness (symptom of helmet removal); 4. Strengthening of the clinic in case of sleep on a pillow;
5. Shooting, pulsating pain when externally affected by the head (touch, wind blow).
In patients with stenosis of the vertebral artery, neuropathologists often observe a vestibular syndrome, in which staggered, unstable, pronounced attacks of dizziness.
Even with uncomplicated current, a brief loss of consciousness can occur with a sharp turn of the head, vibration, pressure on the neck. With such clinical symptoms a person should not drive a car.
Noise, nausea, and hearing loss wash the appearance of a number of secondary pathologies from the inner ear, the brain.
With the traditional roentgenography of the cervical spine, narrowing of the intervertebral discs is seen in the degenerative-dystrophic process, prolapse, hernia.
The task of an X-ray in the presence of a drop attack (sudden drop) is to establish the probability of a blood supply disruption in the vertebrobasilar basin, to identify possible displacement of the vertebrae, instability, scoliosis.
For these purposes, functional shots are performed with maximum flexion and extension of the neck.
Radiographs help to assess the degree of flexion of the cervical region, to exclude or confirm the instability of the vertebrae.
MR angiography of vertebral arteries in stenosis Radiograph in the appointment of radiography reveals the growth of marginal osteophytes in the region of semilunar articulations. Changes are clearly visualized in a direct image. Osteophytes are localized along the upper edge of the contours of the anterior part of the vertebral bodies.
On the lateral roentgenograms of the cervical spine, the status of cervical vertebrae, intervertebral fissures, hyperlordosis (excessive convexity of natural curvature) is studied.
With any of these disorders, there is a decrease in vision, eye fatigue, a pathology of the visual analyzer.
With late therapy, it is impossible to prevent irreversible development of visual impairment by either conservative or operational methods. When radiographing the cervical spine, the shadows of the vessel are not visible.
To study the state of blood supply, it requires contrast angiography, magnetic resonance imaging, dopplerography.
Methods of radiation diagnosis of stenosis of the right or left vertebral artery will be considered below.
Why does the narrowing of the vertebral artery develop?
Disturbance of blood supply to the brain depends on the degree of compression of the vertebral artery. Constriction is caused by atherosclerosis, nervous spasm, external compression of the vertebrae, tumor, thromboembolism.
The cause of blood circulation disorders in the vertebrobasilar basin may be the tortuosity of one or both vertebral arteries. For the treatment of pathology, stenting, balloon angioplasty is used.
The procedures are performed under local anesthesia. The stent is installed through the puncture of the femoral region. The introduction of an endoprosthesis is necessary to maintain the physiological lumen of the vessel.
A few years ago, stenting was carried out under the control of an X-ray. Skopicheskaya cover was made to visualize the introduction of a balloon stent.
On the X-ray television screen, the movement of the balloon from the femoral to the vertebral artery is clearly traced.
The procedure resulted in radiation irradiation of the patient, therefore at the present stage the intervention control is carried out under the cover of ultrasound.
Narrowing of the left vertebral artery: symptoms
Suspected narrowing of the left vertebral artery is possible in the presence of the following symptoms:
1. Headache syndrome is characterized by blunt, burning pain with localization in the parieto-occipital region. Symptom increases with severe physical exertion.
The probable location of morbidity is the superciliary, temporal, parietal zones; 2. Symptoms from the gastrointestinal tract. Nausea and vomiting appear in many patients with vertebrobasilar insufficiency.
It is impossible to fight them with medications. The mechanism of dyspeptic disorders is the transmission of the vertebral artery with impaired blood flow to the intestine; 3.
Disorders of the central nervous system - loss of memory, changes in visual acuity, eye pain; 4. Vestibular disorders - impaired orientation, ear noise;
5. Change in the frequency of contractions of the cardiovascular system, instability of pressure, attacks of angina pectoris.
In addition to surgical and conservative treatment, patients with vertebrobasilar insufficiency should be treated an additional set of medical procedures - physiotherapy, massage, kinesiotherapy (physical therapy movements).
The narrowing of both vertebral arteries is a dangerous pathology, in which serious complications develop.
Roentgenography of the cervical part in the lateral projection with a decrease in the height of the vertebral bodies at the lower level
Difficulties are caused by timely diagnosis of nosology. To detect the disease, not only x-rays, but also other radiation methods of diagnosis are used.
Principles of treatment of vertebral artery syndrome
With the narrowing of both vertebral arteries, the treatment is aimed at eliminating the main pathogenetic links in the process:
1. Elimination of a neurogenic spasm; 2. Improvement of microcirculation of the vertebrobasilar basin;
3. Vertebrogenic effect on the vessel wall tone.
Complex treatment necessarily includes agents that reduce the viscosity of the blood, dilate the vessels - dipyridamole, pentoxifylline, vinpocetine.
Radiography when narrowing the right or left vertebral artery is used not to diagnose the disease, but to identify a possible cause of compression of the vertebral vessel in the neck.
Methods for detecting compression of vertebral vessels (right and left)
Methods for diagnosing stenosis of vertebral vessels on both sides:
1. Magnetic resonance imaging allows to determine the anomalies of the structure of the bone bed, in which the vessels go; 2.
Roentgenography of the cervical region - to detect the instability of the vertebrae, displacement, hernia of the neck, other anatomical structures that interfere with blood flow in the vertebrobasilar basin; 3. Dopplerography helps to estimate deviations of blood flow from normal values.
The more the circulation is reduced, the greater the probability of severe complications in the brain; 4. Duplex scanning - is assigned to detect lesions localized on the inner wall of the vessel;
5. Angiography of the cervical vessels - examination after the introduction of contrast into the vessel. For visualization, CT or MRI can be used, since the methods allow to create a three-dimensional modeling of the neck condition.
To determine the level of blood flow disorders in the brain base area, ultrasound scanning with Dopplerography is performed.
The procedure is applied not only for the detection of blood supply disorders, but also for the purpose of dynamic observation of the nature of microcirculation against the background of treatment with vasodilating drugs.
To determine changes in the brain that lead to similar symptoms, neuroimaging can be used by magnetic resonance imaging.
MRI angiography is considered a rather promising method, which shows the state of transcranial and brachiocephalic arteries.
The study allows you to carefully study the nature of the cerebral blood supply, identify thrombi, stenosis of the vertebral artery.
Magnetic tomography reveals atherosclerotic plaques, determine the features of angiography.
X-ray of the cervical spine is used in conjunction with MRI for additional diagnosis. For maximum information it is recommended to perform functional tests with maximum extension and flexion.
A source: https://secondopinions.ru/suzhenie-pozvonochnoy-arterii-pravoy-levoy
Narrowing of vertebral arteries
As a result of the narrowing of the vertebral arteries, the inadequacy of the arterial blood supply of the brain may occur.
Atherosclerotic mechanism of disorders of cerebral circulation, according to De Baeckie, is observed in approximately 40% of cases of all disorders of cerebral circulation.
Occlusion of arterial vessels can be partial and complete; the length of the blockage can be short or long, throughout the entire artery.
Symptoms of narrowing of the vertebral artery
Occlusion of the vertebral artery is indicated by signs of insufficiency of the arterial vessels of the base of the brain: visual disturbances (cortical origin) and symptoms cerebellar lesions (imbalance, diplopia, bilateral blindness or hemianopsia), as well as bilateral disorders of sensitivity and movements expressed is different. These violations can be transient or permanent.
Diagnosissclerotic narrowing of the vertebral arteries can be suspected in the usual clinical study of the patient on the basis of his anamnesis (transient neurological symptomatology - paresis and paralysis, "fibrillation of symptoms"), systolic noise on the arterial vessels, a symptom of loss of consciousness with unilateral compression of the carotid arteries.
In electroencephalography, pathological changes are found only with pronounced neurologic symptoms, which reduces the value of this method of investigation.
In some cases, electrical activity increases when the carotid artery is pressed on the other side or the head is raised sharply.
Topical diagnosis using electroencephalography is not possible.
The most accurate data on the localization and spread of lesions can be obtained with the arteriography of vertebral arteries.
It should be made as early as possible, especially after an attack of arterial insufficiency of the head brain, and if the symptoms of brain ischemia do not pass, then this study is conducted as an emergency intervention.
Arteriography of the vertebral artery is done by percutaneous puncture of the subclavian artery in the supraclavicular area. Enter 20 ml of 50% triootrast.
It is necessary to examine the arterial vessel on the other side, since bilateral lesions are not less than in 25% of cases. An X-ray is taken at the end of the contrast solution.
The investigation is then carried out on the opposite side.
Partial narrowing of the vertebral artery, visible on the arteriogram in the form of "filling defects "erosion" of the artery wall contours, is an indication for the operation. If there is complete blockage, the vessel is not filled with contrast solution and is not completely visible on the arteriogram.
Treatment of narrowing of the vertebral artery
The success of surgical treatment depends first of all on how early the operation is performed after the onset of the disease.
In some cases, the operation is successful in the later period. The purpose of the operation is to restore the blood supply to the brain.
Two methods of operation are used: endarterectomy or bypass shunting with a plastic prosthesis.
Intimendarteriectomy is the removal of the altered intima along with a sclerotic plaque and a thrombus that overlaps it.
The endarterectomy of the vertebral artery because of its small caliber is performed from the lumen of the subclavian artery.
The latter for this is dissected lengthwise over the site of the vertebral artery distalisation.
In the case of simultaneous occlusion of the same-named artery of the opposite side, special measures are needed to protect the brain from ischemia for the duration of the operation.
For this purpose, a temporary external or internal (through the lumen of the artery) is applied by a thin polyethylene tube. In addition, the decrease in blood flow is compensated by increased arterial pressure by the administration of norepinephrine.
Blood coagulation in the temporary by-pass shunt is prevented by the administration of heparin.
In most cases, however, no special brain is from ischemia to the period of the surgical intervention (5-30 minutes) is not required, since the collateral blood supply is quite sufficient.
Results of treatment
The operation brings either complete relief from symptoms of insufficient blood supply to the brain, or a significant improvement in the condition. The results of treatment, traced for 5 years, remained stable.
The best effect is observed after the operation done at the stage of sclerotic narrowing of the vessel, rather than its occlusion. With complete blockage of the vessel, the operation is successful if it is performed soon after the onset of the disease.
Improved diagnostics and earlier application for operational help will further improve results of surgical treatment of sclerotic lesions of the main arterial vessels supplying brain.
A source: http://surgeryzone.net/info/informaciya-po-sosudistoj-xirurgii/suzhenie-pozvonochnyx-arterij.html
symptoms, treatment and microbial 10
The method of therapy and the fight against its consequences directly depend on the form of the disease and its localization. Stenosis of the vertebral artery may be:
Causes of the disease
There are three main causes of stenosis of the vertebral artery:
- Genetic predisposition. It can lead to congenital disorders of the very structure of the vessels. If the disease does not progress, then with him live a normal life, without obvious limitations.
- Acquired factor. Clogging of the vessels is provoked by the following pathologies: atherosclerosis, metabolic disorders and diabetes. For this reason, a compulsory treatment of the vertebral artery is necessary.
- Traumatic factor. Narrowing of the vertebral artery of the artery can occur due to a bruise, fracture or formation of bruising at the site of the injury. In this case, it is necessary to prescribe surgical treatment in order to eliminate the causes of blockage of the artery.
The causes of the disease are related to the intrauterine development of the child:
The syndrome is expressed in a peculiar way, so patients note the following symptoms:
- excruciating headache.
It can be stinging or pulsating, spreading to the temple, crown or supraorbital region.
Peculiarity: pain is localized either in the right or left side of the head. The pain persists the patient constantly, but is especially intensified during walking or during sleep, if the position of the head or body predisposes to it.
Much less often the pain is paroxysmal. Often patients say that the pain has stopped, but they could not find a logical explanation for this. The reason is the position of the head. But there are no general rules about what the position of the head should be, so that the pain disappears;
- visual impairment (decreased acuity, a feeling of sand in the eyes, a veil in the eyes), or pain in the eyeballs;
- auditory or vestibular disorders, for example, dizziness, loss of stability, noise in one ear, hearing loss;
- cardiac manifestations, if a person has cardiovascular diseases, for example, hypertensive heart disease, ischemic.
If the patient is suffering from coronary heart disease, angina attacks can occur in the form of acute pain in the heart zone.
The development of the syndrome, in which the vertebral artery suffers, passes in two stages - dystonic and organic. Symptoms and treatment for each stage vary and it is important to establish the degree of arterial damage by examining information about the signs of the course of the disease.
In the first case, a person begins to experience such symptoms as:
- constant pain in the temporal and occipital region of the head, which is enhanced by movement or being in one position for a long time;
- transient dizziness of varying intensity;
- violations of visual perception, expressed in the appearance of "flies "snowflakes". One-sided decrease in acute peripheral vision is also observed.
Symptoms of the organic course of the disease have the following symptoms:
Diagnosis of vertebral artery syndrome involves several different studies.
First of all, the diagnosis is based on those data that can be obtained from the clinical picture of the disease. It is about the patient's complaints, as well as about the information that the doctor received during the neurological examination.
Quite often, diagnostics make it possible to detect the tension of the occipital muscles, the presence of difficulty in turning the head, pain when pressing on the processes of the first and second cervical vertebrae.
In addition, diagnosis means mandatory holding:
Diagnosis of circulatory disorders in the vertebral artery by ultrasonic dopplerography (UZDG). The method of studying the arteries of the vertebrobasilar basin and carotid is called the ultrasound of the aortic arch. At the same time, carotid arteries are fully examined, and vertebral arteries are partially examined.
Most often, the examination begins with a blood test, which shows possible problems with the arteries.
Also standard procedure is the measurement of blood pressure, this indicator can not only reveal the arterial hypertension, but also to determine the pressure on the vessels, and therefore, to clarify the risk factors for different diseases.
After this, additional diagnostics can be assigned.
The disease can be detected during the first examination with a neurologist. The doctor listens to the patient's complaints about the general condition, takes into account possible violations in the cervical department, and writes out the direction for ultrasound diagnosis.
If during the examination it was revealed a narrowing of the lumen in the diameter of the vertebral artery up to 2 mm at the norm, mm - this is considered a diagnostic symptom proving the presence of the disease. If necessary, angiography is carried out - X-ray diagnosis of the vessels by the introduction of a contrast agent, clearly demonstrating their current state.
If the disease is suspected, the doctor should prescribe a referral for ultrasound of the vessels. This diagnosis allows you to determine the diameter of the artery.
Anomaly is the narrowing of the internal diameter, the norm varies in the range - 3, 8 mm.
A pathological change is considered to be a diameter of less than 2 mm.
According to the indications, tomography and angiography of arteries with contrast agent are performed.
These studies help to obtain a complete picture of vascular anomalies.
Often, hypoplasia is exacerbated by vertebral disorders located in the cervical region. This can also be identified during the diagnosis.
The following methods allow you to put the right one:
please provide a valid link
You can treat stenosis with three effective methods:
Modern medicine offers many methods of treating arteries, both conservative and operational. However, it is these diseases that remain one of the most difficult and difficult to treat.
This is largely due to the fact that the processes occurring in the left and right arteries of the extremities, the main vessels, vessels brain and heart, many factors influence, for example, the composition of blood, the work of the heart muscle, the state of veins, age changes in the tissues.
Therefore, treatment should be carried out in a comprehensive manner, taking into account all possible causes.
Depending on the stage of development and the presence of factors influencing the clinical picture, the treatment of vertebral artery syndrome can be conservative or surgical intervention will be required. In the dystonic course of the syndrome, a good result is obtained by the drug method, in which the patient is administered medications that stimulate blood flow and improve the chemical composition of the blood.
Simultaneously, one can prescribe physiotherapy, which will help increase the clearance between the walls of the arteries and eliminate the early stages of osteochondrosis.
In some cases, in the treatment of cervical osteochondrosis, special gymnastics deserves good feedback, which not only reduces discomfort, but also improves cerebral blood supply.
Treatment is carried out by two methods:
- Conservative. Assumes the introduction of drugs that improve blood properties, blood supply to the brain and metabolic processes in it. Such methods do not completely eliminate the disease, but only provide protection of the brain from ischemic anomalies. For this, various medications are used, in particular, blood-thinning agents.
- Surgical. Used in situations where it is impossible to compensate for cerebral circulation in other ways. Experienced surgeons perform an endovascular operation, the purpose of which is to insert a stent into the lumen. It is a special expander that increases the diameter of the artery, which normalizes blood flow.
To eliminate vascular manifestations, experts prescribe to patients drugs that improve the nutrition of the brain.
Medications activate metabolic processes in the nervous system, protect her cells from the repeated action of the aggressor.
Conservative treatment relieves only of symptoms - the consequences of vascular lesion.
Since atherosclerosis and ischemic heart disease are chronic progressive diseases, it is very important to pay sufficient attention to prevention.
After all, this is how you can prevent the disease itself, as well as slow its progression.
the task of such measures is to optimize the composition of the arterial blood so that it does not have factors contributing to the formation of plaques.
Try not to lift and hold weights on outstretched arms. You must competently learn to carry weights in order not to damage your back. With a smooth posture, you need to squat, take a load and straighten your legs with it.
In this case, place your hands as close to the body as possible. Distribute the load evenly, so you do not need to carry it in one hand, if you can take two bags in both hands.
Use bags, trolleys and suitcases on wheels to transport heavy items.
A source: https://praviloserdca.ru/arteriya/pozvonochnye-arterii-i-ih-patologii