Vertebral artery occlusions fall under the umbrella of Vertebrobasilar Disease (VBD), otherwise known as Vertebrobasilar Insufficiency (VBI). The condition is defined by inadequate blood flow to the back portion of the brain responsible for coordination, vision, balance, consciousness and other essential functions. Two separate vertebral arteries, which from the basilar artery, feed in this region. Over time, atherosclerosis causes plaque buildup leading to a blockage of the two arteries. A complete blockage or severe restriction of blood flow is an ischemic event and holds serious consequences. In other words, vertebral artery occlusions are extremely serious. A transient ischemic attack (TIA), or "mini-stroke," causes a temporary loss of brain function, but a full-blown stroke is the next step. Thankfully, there are warning signs and symptoms, as well as treatments, for VBD.


Atherosclerosis is considered the most common cause of vertebrobasilar insufficiency. It is capable of affecting every artery in the body. Atherosclerosis is the gradual thickening or hardening of the arteries caused by a buildup of plaque in the inner layer of the artery. Risk factors for atherosclerosis include high blood pressure, smoking, diabetes, and high cholesterol.


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Vertigo and Vertebrobasilar Insufficiency

Feelings of vertigo or dizziness with no apparent cause are the most commonly reported symptoms associated with vertebrobasilar insufficiency although it can be caused by other conditions as well. The symptom is, in itself, a reason to seek immediate medical attention. Vertigo from a vertebrobasilar insufficiency can be brought on by turning the head to the side, which temporarily blocks the contralateral vertebral artery decreasing blood flow.


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Double Vision

Diplopia or double vision is another reason to seek immediate medical attention as, outside of a blow to the head, this symptom is not a regular occurrence. If vertigo accompanies double vision, it is even more important to seek medical attention, as many people later diagnosed with vertebrobasilar insufficiency first present with these two symptoms.



Sudden and Severe Weakness

This is often referred to as a “drop attack.” One minute you’re walking down the street and the next moment you’ve taken a knee. The weakness may last for only a second or two, or up to half a minute. A drop attack is a strong sign that you may have just had an ischemic incident caused by vertebrobasilar insufficiency. Many people tell their doctors the events feel like panic attacks.


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Difficulty Swallowing

The vertebral arteries are responsible for swallowing. If you don’t suffer from acid reflux issues but suddenly are struggling to swallow, it is a good idea to seek medical care. The quicker you can see a doctor and have your condition diagnosed, the better chance you have of stopping its progression.


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Additional Symptoms of Vertebrobasilar Insufficiency

Numbness in the hands or feet, slurred speech, a feeling of sudden confusion, nausea, loss of balance, and a brief loss of vision in one or both eyes are all symptoms that can be caused by vertebrobasilar insufficiency or other serious conditions, and that emergency medical attention is needed. Everyone feels nausea from time to time, but if it's coupled with one or more of any of these symptoms, it's imperative that you get to a hospital.


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Diagnosis of Vertebrobasilar Insufficiency

If your doctor suspects vertebrobasilar insufficiency, he or she will likely order a magnetic resonance angiography (MRA) and a standard (x-ray) angiography to study the vertebral and basilar arteries. If the physician suspects a mini-stroke or stroke, he or she will also likely order a CT or MR scan of the brain for confirmation.


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Treatment of Vertebrobasilar Insufficiency

Whether or not your doctor foresees endovascular or surgical options in your future, you can be sure he or she will recommend lifestyle changes. Topping this list is the immediate cessation of smoking. Additionally, your doctor will suggest a healthy, plant-based diet low in saturated fats, exercise, and weight loss if appropriate. They may also prescribe medication that controls high blood pressure, lowers blood cholesterol levels, blocks platelet function, and controls diabetes, if necessary.


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Endovascular Repair For Vertebrobasilar Insufficiency

In many instances, lifestyle changes are not enough to fully manage vertebrobasilar insufficiency. Before, or in lieu, of invasive surgery, your doctor may try to treat this condition with endovascular repair, wherein a catheter inserted into the groin is used to place a balloon that will inflate the artery wall. A metal stent or multiple stents will then be inserted to keep the artery open and return blood flow.


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Surgical Options for Vertebrobasilar Insufficiency

A blockage's proximity to the brain will determine available surgical options. The farther away, the more likely your surgeon will be willing to undergo one of three procedures: bypass grafting, where the surgeon bypasses the blockage with a new blood vessel; arterial transposition, where the surgeon attaches a portion of the problematic artery to a healthy one nearby; and endarterectomy, wherein the doctor removes the plaque responsible for the blockage. These surgical options can drastically reduce the likelihood of a patient's vertebrobasilar insufficiency progressing to a vertebral artery occlusion.


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