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Vertebrobasilar insufficiency (VBI) describes a temporary set of symptoms due to decreased blood flow in the posterior circulation of the brain. The posterior circulation supplies the medulla , pons , midbrain , cerebellum and (in 70-80% of people) supplies the posterior cerebellar artery to the thalamus and occipital cortex . [ 1 ]
The Vertebral Artery Test or Wallenberg Test is a physical exam for vertebral artery insufficiency. Commonly, the VA test involves cervical spine motion to an end-range position of rotation, extension or a combination of both. At this point, the physician assesses for vertebrobasilar insufficiency (VBI) symptoms.
The portion of vertebral arteries located within the skull (intracranial) have diameters of 3.17 mm. The intracranial length for the left vertebral artery (32.4 mm) is longer than the right (31.5 mm). The angle where vertebral arteries meet the basilar artery (vertebrobasilar junction), is 46 degrees. [10]
Vertigo or dizziness; Weakness of limbs; Symptoms are frequently worsened by a Valsalva maneuver, or by being upright for long periods of time. The reason that being upright is problematic is that gravity allows increased interaction between the brain stem and the top of the spinal column, increasing symptoms.
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Dizziness affects approximately 20–40% of people at some point in time, while about 7.5–10% have vertigo. [3] About 5% have vertigo in a given year. [10] It becomes more common with age and affects women two to three times more often than men. [10] Vertigo accounts for about 2–3% of emergency department visits in the developed world. [10]
Binswanger in 1894 was the first to claim that white matter atrophy caused by 'vascular insufficiency' can result in dementia. He described a patient who had slow progression of dementia as well as subcortical white matter atrophy, ventricle enlargement, aphasia , hemianopsia , and hemiparesis . [ 9 ]
Schematic representation of antibody. Anti-cardiolipin antibodies (ACA) are antibodies often directed against cardiolipin and found in several diseases, including syphilis, [1] antiphospholipid syndrome, livedoid vasculitis, vertebrobasilar insufficiency, Behçet's syndrome, [2] idiopathic spontaneous abortion, [3] and systemic lupus erythematosus (SLE). [4]