Preventing Vertebral Artery Occlusion: What You Need to Know

Atherosclerosis is the most common underlying cause of vertebrobasilar insufficiency, and it can affect any artery in the body. It works slowly, thickening and hardening artery walls as plaque accumulates in their inner lining.

The main risk factors are high blood pressure, smoking, diabetes, and high cholesterol. None of those are guarantees, but if several apply to you, it's worth having a conversation with your doctor sooner rather than later.

Unexplained dizziness or vertigo is the most commonly reported symptom of vertebrobasilar insufficiency, and on its own it's reason enough to get checked out.

With VBI specifically, vertigo can be triggered by turning your head to one side, which temporarily compresses the opposite vertebral artery and reduces blood flow. If that's what's happening to you, mention it to your doctor by name. It's a meaningful clue that changes the conversation.

Double vision doesn't just happen. Outside of a knock to the head, it's not something you should write off or wait out.

If vertigo shows up alongside it, don't delay: the combination of these two symptoms is often the first sign that something is going wrong with vertebrobasilar blood flow, and early diagnosis makes a real difference.

This is sometimes called a "drop attack," and the name is apt. One moment you're walking normally, and the next your legs give way. It may last only a second or two, then pass as suddenly as it came. That fleeting quality makes it easy to brush off, but a drop attack can be a sign of an ischemic incident, and it deserves medical attention.

Many people describe the sensation as feeling like a panic attack, which is part of why it so often goes unreported. If it's happened to you, tell your doctor.

The vertebral arteries play a role in the mechanics of swallowing, so if you're suddenly struggling with it and reflux isn't something you deal with, that's worth paying attention to.

It may feel like an odd, minor thing, but getting it checked out early gives you the best chance of catching the condition before it progresses.

Numbness in the hands or feet, slurred speech, sudden confusion, nausea, loss of balance, and brief vision loss in one or both eyes can all point to vertebrobasilar insufficiency or other serious conditions.

If any of these hit you out of nowhere, especially in combination, don't wait to see if they pass. Get to a hospital.

If your doctor suspects vertebrobasilar insufficiency, they'll likely order a magnetic resonance angiography (MRA) and a standard angiography to get a close look at the vertebral and basilar arteries.

If a mini-stroke or stroke is on the table, a CT or MRI scan of the brain will typically follow. It can feel like a lot of imaging, but each test is filling in a different part of the picture.

Whatever stage things are at, your doctor is almost certainly going to start with lifestyle changes. Quitting smoking is the most urgent item on that list. From there, expect recommendations around diet, exercise, and weight management where relevant.

Depending on your specific situation, medication may also come into play to manage conditions such as blood pressure, cholesterol, platelet activity, and blood sugar. These changes aren't just supportive measures; for many people, they're genuinely effective at slowing progression.

When lifestyle changes aren't enough on their own, endovascular repair is often the next step before considering open surgery. A catheter is inserted through the groin and guided to the narrowed artery, where a small balloon inflates to widen it.

One or more metal stents are then placed to hold the artery open and keep blood flowing. It sounds involved, but it's far less invasive than surgery and has a strong track record.

When a blockage needs a more direct fix, three surgical approaches are available. Bypass grafting routes blood around the blockage through a new vessel. Arterial transposition connects a segment of the affected artery to a healthy one nearby.

Endarterectomy removes the plaque directly. Which option your surgeon recommends depends largely on how close the blockage is to the brain, but any of the three can significantly reduce the risk of things progressing to a full vertebral artery occlusion.