Narrowing of the v4 segment of the right vertebral artery, hypoplasia. Congenital defect of the vertebral artery - how to live with it? The main consequences include

Vertebral cervical artery syndrome is a complex of symptoms that arise in the brain in response to a violation of the patency of one or both vessels with the same name. It is these arteries that are the “founders” of the vertebrobasilar blood pool, supplying blood to the posterior parts of the brain (the second brain pool is formed from carotid arteries).

Reasons for the development of the disease

Vertebrogenic, that is, caused by problems of the spine. The vertebral arteries in the neck pass in close proximity to the processes of the cervical vertebrae, and some of their diseases affect the vessels supplying the brain.
Not related to spinal pathology. This includes both pathological changes the arteries themselves and nearby soft tissues.

Non-vertebral causes include:

Atherosclerosis of the vertebral arteries: most often it is the left vessel that suffers, since in most people it arises directly from the arch of the subclavian artery;
Congenital anomalies of arterial development;
Neck muscle spasm.

Vertebrogenic causes are as follows:

Scoliosis of this part of the spine;
Instability of the cervical vertebrae due to injury or dysplastic processes;
Degenerative processes in intervertebral disc(osteochondrosis);
An additional cervical rib that blocks the blood flow in the vessel.

How does the symptom complex manifest itself?

Symptoms of vertebral artery syndrome are as follows:

Strong headache, which has the following characteristics:
- Occurs in one half of the head;
- Any type of pain: shooting, bursting, dull, throbbing;
- It can disappear in a certain position of the head;
- It intensifies while walking (maybe during sleep, if the head has just taken a “predisposing” position);
- The occurrence of pain may be associated with hypothermia of the neck or prolonged uncomfortable position of the head;
- Different duration of the attack.
Visual impairment: “sand”, “flies”, a transient “veil” before the eyes.
Maybe in the eyeballs.
Dizziness.
Noise in ears.
There may be nausea and vomiting.

Symptoms of vertebral artery syndrome can develop gradually, or they can occur suddenly when the head position changes, as a result of which blood flow through the artery stops completely. When this situation occurs, it is called a drop attack: a person suddenly falls, while his consciousness is completely preserved (he describes it as “his head floating away somewhere”).

Everything about the treatment of hypoplasia of the vertebral arteries

Most diseases affecting the brain are vascular in nature. Hypoplasia is no exception. This congenital pathology, affecting the intracranial blood supply. The essence of the disease, its symptoms, diagnosis and treatment - this is the subject of research in this article.

general information

The Circle of Willis is the basis for normal blood supply to all systems of our body. This circle is formed by large vertebral arteries (left and right branches). The development of the vertebral arteries occurs evenly - with normal conditions. The subclavian artery circulates in the direction of the cranial cavity, which branches at the entrance.

The medical term “hypoplasia” means underdevelopment of the tissues of an organ. Pathologies can be congenital or acquired, but in the case of arterial hypoplasia, the first option is more common.

There is the following division of pathology:

left-handed;
right-sided;
bilateral.

Since the adaptive capabilities of our body have a limit, hypoplasia quickly leads to exhaustion and decompensation. At this stage, urgent surgical intervention is required.

Hypoplasia of the right vertebral artery

Abnormal intrauterine development can lead to hypoplasia affecting the right vertebral artery. Pathology can be provoked by bruises or radiation exposure of a pregnant woman, as well as prolonged overheating (beach, sauna), nicotine and alcohol. The influenza or rubella virus can also cause Negative influence per child.

The patient's condition begins to deteriorate in mature age. Intensity increases the following symptoms:

headache;
dizziness;
arterial pressure;
drowsiness;
emotional disturbances (lethargy, frequent mood swings, depression);
vestibular disorders;
insensitivity.

The disease does not require special treatment - the body independently finds a way to compensate for the blood supply. Only in in rare cases If something goes wrong, then medical intervention is required. Accompanying illnesses- the main trouble of pathology. For example, atherosclerosis provokes additional problems with blood circulation, since the vessels narrow significantly. Patients complain of weather sensitivity and sleep disturbances.

It is impossible to get rid of the disease using conservative methods, but in some cases vasodilators are used, and the doctor may prescribe surgery.

Hypoplasia of the left vertebral artery

Symptoms of left-sided arterial hypoplasia are closely related to circulatory pathologies and do not appear immediately. Hemodynamic dysfunction results in vascular obstruction, blood stagnation, and organ ischemia. Adaptive mechanisms smooth out the development of pathology, therefore catastrophic consequences They do not cover the body instantly - it is a long process, stretched over years.

The clinical picture increases with age-related changes in tissues and organs, but the primary stages can elude the medical eye. Therefore, it is necessary to study external manifestations illness.

An alarm bell is a pain syndrome that affects the spine (its cervical region). If other symptoms are not observed, put correct diagnosis difficult. Another typical manifestation hypoplasia - anastomosis (branches of the main vessels begin to connect with each other). This is how the body compensates for the underdevelopment of the vertebral arteries. The effect may be lost if vascular patency deteriorates.

Left-sided hypoplasia is fraught with hypertension - an increase in blood pressure. This is a secondary ailment, a kind of signal that the body is trying to adapt to the current situation.

Causes and likely consequences

Factors contributing to the occurrence of pathology develop even before a person is born - at the stage of intrauterine development. This birth defect, therefore, parents should take into account many nuances even at the stage of planning pregnancy.

The causes of future hypoplasia are:

injuries (for example, bruises) of a pregnant woman;
maternal infectious diseases;
radiation;
ionizing radiation;
abuse of nicotine, alcohol, certain medications, drugs, poisonous chemical compounds during the period of gestation;
genetic predisposition to diseases of the circulatory system.

Due to the situations mentioned above, hypoplasia does not always develop - these factors only increase the likelihood of pathology occurring.

Cases of children being born with hypoplasia for no apparent reason have been recorded. Modern doctors are still finding it difficult to develop a unified concept that explains this phenomenon. There are a number of provocateurs that accelerate the manifestation of pathology.

subluxations of the cervical vertebrae and spondylolisthesis (leads to deformation of the spinal canal);
osteochondrosis (bone growths begin to compress the artery);
ossification affecting the vertebral-occipital membrane;
the formation of blood clots inside the abnormal artery;
vascular atherosclerosis.

What are the dangers of pathology?

The defect can “dormant” in the body for a certain period of time and appear in adulthood. Often, hemodynamic disorders are mistakenly attributed by doctors to diseases that have similar symptoms. Therefore, the diagnosis of hypoplasia must be given the closest attention.

Catastrophic changes affect the area of the bone canal and the artery flowing into it. With hypoplasia, the brain tissue is supplied with blood much worse, which leads to dire consequences.

It is impossible to predict all side effects, but some of them are quite unpleasant:

headaches (severe and recurring);
increased fatigue;
hearing impairment;
decreased visual acuity.

Symptoms

The disease is characterized by a variety of symptoms, with different patients"gentleman's set" may differ. This concerns the general underdevelopment of the vertebral arteries and the intensity of the pain syndrome. Often, the patient learns about his diagnosis during a routine medical examination - the symptoms are difficult to differentiate, and the clinical picture is blurred.

The basic signs of vertebral artery hypoplasia are:

headaches (intensity may vary);
causeless and frequent dizziness;
nervous dysfunctions;
distorted spatial perception;
frequent high blood pressure;
violation of fine movements;
problems with sensitivity (can affect different areas of the body, a classic example is the limbs);
motor disorders (paralysis, paresis);
visual hallucinations;
unsteadiness when walking;
loss of coordination of movements.

The last point manifests itself in the form of unnecessary collisions with objects physical world, falls and the feeling of being on a carousel for a long time. The intensity of manifestations increases with the aging of the body.

Diagnostics

Diagnosing hypoplasia in the early stages is extremely difficult. If there is any suspicion of this disease, you should immediately contact a neurologist. The doctor examines the patient, listens to his complaints and prescribes an instrumental examination (ultrasound of the vertebral arteries).

There are three key methods for diagnosing hypoplasia:

Ultrasound of the vessels of the neck and head. The emphasis is on duplex angioscanning (an image of the artery is recorded, the intensity, type and diameter of the blood flow are assessed). The method is considered safe and does not threaten the patient’s health.
Tomography of the neck and head area followed by contrast enhancement. It is carried out using magnetic resonance and computed tomography scans, while the vessels are filled with contrast agents.
Angiography. Features of the course, anatomical structure, connections of vascular formations - all this is recorded graphically. X-ray equipment allows you to evaluate the vertebral artery by filling it with contrast. The image is displayed on the monitor, and a large artery on one of the limbs is punctured to introduce contrast.

Treatment

Hypoplasia of the vertebral artery (right-sided and left-sided) is much more common than many might think. Approximately 10% of the world's population suffers from of this disease. In most patients, the body's compensatory capabilities are strong enough to cope with the pathology for many years.

The disease begins to manifest itself in old age or in adulthood (depending on the individual parameters of the body). Emotional and physical stress can cause atherosclerosis, and in the long term - disruption of the functionality of compensatory mechanisms.

Drug therapy

Conservative treatment involves the administration of drugs that improve blood properties, metabolic processes in brain tissue and blood supply to the brain. This approach will not eliminate the problem, but the brain will be protected from ischemic changes. Your doctor may prescribe the following medications:

Actovegin;
trental;
Ceraxon;
vinpocetine;
cinnarizine;
thiocetam;
Cerebrolysin;
blood thinners.

Surgical intervention

Appointed only in emergency situations when it becomes obvious that it is impossible to normalize cerebral blood flow. Neurovascular surgeons of our time give preference to endovascular operations. The essence this method consists of introducing a stent (a special dilator) into the lumen of a narrowed vertebral artery.

The stent expands the diameter of the area that has undergone pathological changes, thereby restoring normal blood supply. The intervention is somewhat reminiscent of angiography, so it is often carried out in parallel with this diagnostic method.

Folk remedies

Special folk remedies against hypoplasia does not exist. But many have been developed good recipes, allowing you to fight satellite diseases (the same as atherosclerosis).

Here are a few examples from the traditional medicine industry:

olive oil (it is recommended to drink three tablespoons daily for preventive purposes);
honey (there are many variations with mixing lemon juice, vegetable oil and honey followed by consumption on an empty stomach);
potato juice (squeezed from one potato daily);
sophora japonica (a glass of chopped plant pods is mixed with a half-liter bottle of vodka and consumed after three weeks of infusion three times a day, a tablespoon);
dill seeds (relieve headaches);
garlic (lemon zest mixed with a head of garlic and 0.5 liters of water - consumed after four days of infusion);
lemon balm decoction (copes with tinnitus and dizziness).

Centers for alternative (special Chinese and Tibetan) medicine are gradually ceasing to be considered exotic. Meanwhile, their methods are very effective.

It is worth noting:

massage;
acupuncture;
gymnastic complexes.

These methods are not always recognized by official medicine, so it is worth consulting with your doctor before turning to alternative institutions. Sometimes it is advisable to combine conservative and traditional therapy— most importantly, make sure that the specialists of the alternative center have the appropriate certificates.

Causes and consequences of tortuosity of the vertebral arteries

Often, hypertension and neurocirculatory disorders are a consequence of arterial tortuosity. This anomaly is characteristic of the carotid and vertebral large vessels. In the resulting bends of the arteries, blood flow slows down and this adversely affects general health person. Due to the presence of such an anomaly, the risk of developing ischemic stroke increases by as much as 30%. For the same reason, violations occur cerebral circulation.

Causes of the anomaly

Tortuosity of the vertebral arteries in most cases is congenital and inherited. This is due to the fact that in the tissues of blood vessels the number of elastic fibers prevails over the number of collagen, as a result of which large arteries (vertebral and carotid) are deformed. Tortuosity appears against the background of wear and thinning of arterial structures. Impaired blood flow also occurs against the background of atherosclerosis - the formation cholesterol plaques in the lumens of blood vessels.

Symptoms

Tortuosity of the vertebral arteries has no symptoms in the early stages and the body adapts to such an anomaly over time. The threat of developing micro-strokes and ischemia appears if tortuosity is accompanied by atherosclerosis - plaques form in the bends of the vessels and cerebral circulation is disrupted. Deformation of blood vessels most often occurs at the places where it enters the bone canal. The most pronounced tortuosity of the vertebral arteries occurs in the area of the 1st and 2nd vertebrae of the cervical spine, where, due to deformation, kinks, loops, aneurysms and spurs can form in the walls of the vessel.

Treatment

The anomaly itself is not life-threatening if you pay close attention to your health and prevent the development of atherosclerosis. To do this, you need to eat right, undergo regular examinations with a cardiologist and not abuse bad habits. For tortuosity of the vertebral arteries, medications that lower blood pressure and medications to eliminate signs of vestibular disorders may be prescribed. In some situations it is required surgery if bends are found in the 1st segment of the vertebral artery and there is a risk of acute ischemic stroke.

Quite a lot important in the abnormal development of the embryo is influenced by toxic substances. Such substances can be not only carcinogens contained in tobacco or some food products, but also some medications. Alcohol and drugs also negatively affect fetal development.

Symptoms

The symptoms of the disease are extensive and quite varied. Many diseases have similar symptoms, so diagnosing the disease is quite difficult. In addition, each individual case may have its own distinct symptoms. However, all the symptoms have a common focus: they are all associated with disorders of the brain.

The most common symptoms are headaches, which may come on suddenly. Their duration is paroxysmal in nature, the nature of the pain is acute. Dizziness is no less common.

If there is a lack of blood supply to the cerebellum, symptoms associated with impaired motor coordination may occur. Depending on the degree of the disorder, patients may feel general disorientation in space or impaired fine motor skills.

If the lack of blood circulation mainly occurs in occipital part brain, hallucinations or decreased vision may occur.

Depending on the specific brain disorder, blood pressure or sensory disturbances may occur. In some cases there are movement disorders, up to temporary paralysis.

Consequences

Basically, the pathology does not have significant consequences. But in some cases, when certain factors coincide or the pathology is significant, the consequences of hypoplasia of the right vertebral artery can be significant. For example, the presence of an open Wellisian circle in combination with the above anomaly can lead to a cerebral stroke.

The remaining consequences of the pathology are not significant, but can lead to some loss of comfort in life. These include impaired coordination of movements, fainting, decreased vision, headaches, and nausea. In addition, patients get tired faster during physical activity; fatigue is not completely eliminated with rest.

Loss of short-term memory, drowsiness, and decreased mental activity of the brain are also possible.

But the occurrence of such consequences in most cases occurs already in adulthood and old age. This is explained by a decrease in the elasticity of the walls of blood vessels and their cluttering with waste products, for example, cholesterol.

Treatment

Currently, there are two methods of treating hypoplasia of the right vertebral artery: drug therapy and vascular surgery to increase their lumen.

Most often used drug therapy, since the pathology is generally not significant, and the lumen of the blood ducts is narrowed slightly. For this purpose, vasodilators, blood thinners and nootropic drugs are used.

Surgical enlargement of the lumen bloodstream carried out only in as a last resort when drug therapy fails and there is a possibility severe consequences from the development of the anomaly.

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In practical medicine, the name “Hypoplasia of the right vertebral artery” means a specific pathological condition, which is characterized by underdevelopment of the vessel, which as a result affects hemodynamics in the brain, especially in its posterior parts, where the circle of Willis is formed from the vessels of its basin. Normally, a person has two vertebral arteries, which branch from the subclavian artery and are directed to the skull in a manner specific to them. The peculiarity of the location of the vessels in the cervical region is that they pass in a special intermittent canal, which is formed due to the presence of vertebral foramina in the transverse processes of the cervical vertebrae C7-C2. At the level of the second cervical vertebra, the artery forms a siphon (physiological bend) to reduce the pulse wave and blood pressure impulse before entering the cranial cavity. In this case, hypoplasia of the vertebral artery is most often observed in the area from the point of branch from the larger vessel to the moment of bending.

The essence of the concept of “hypoplasia of the right vertebral artery” and the pathogenesis of the process

Hypoplasia means underdevelopment of a vessel, which is characterized by a significant narrowing of its lumen at the site of passage in the bone canal. This narrowing, associated with impaired development of the organs of the neck and spinal column, leads to a slow increase in symptoms. It is quite rarely possible to recognize it during an initial non-specialized examination, since the patient’s complaints of pain in the cervical spine are more pronounced. However, hypoplasia of the right vertebral artery is in no way associated with cervical pain syndrome, since at this level it does not give off branches, which means that the organs of the neck cannot experience ischemia due to its narrowing. Therefore, the underlying pathology is corrected, after which the symptoms of dizziness go away on their own.

In fact, to make a diagnosis, one must be guided by the principles of pathological relevance, since with deformations of the cervical vertebrae, the disease can develop in unilateral and bilateral variants. This process is extended over time and proceeds much more favorably due to a compensatory increase in blood flow through intact vessels with an increase in their lumen. Pathology is given little importance due to the special structure of the cerebral circulation circuit, which is entirely built on a wide anastomosis of arteries. In this case, only the posterior parts, the brainstem and the cerebellum can suffer from bilateral vertebral artery hypoplasia.

Compensation for hypoplasia by the physiological capabilities of the body

If there is isolated hypoplasia of the right vertebral artery, then the symptoms include a number of nonspecific signs that occur as a result of functional disorders of the blood supply to the posterior parts of the brain. In fact, if it manifests itself, then the process is clearly decompensated and requires surgical treatment. However, until this moment, while the brain does not experience circulatory deficiency, for a pathology such as hypoplasia of the right vertebral artery, treatment should include only pharmacological agents, dilating the vessels of the arterial bed.

Hypoplasia of the right vertebral artery: diagnosis

Recognition of the disease is carried out when initial examination from a neurologist. They take into account complaints of incoordination, rare fainting, and staggering when standing up. Assessing them, as well as the likelihood of disturbances in the structure of the cervical spine, the neurologist has the right to refer the patient to ultrasonography vertebral arteries. At the same time, the narrowing of the lumen to 2 mm in diameter (normally 3.6 - 3.8 mm) is a clear diagnostic sign morphologically confirming the presence of the disease. Angiography with contrast injection can also be performed.

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Right vertebral artery hypoplasia is a disorder in which the right vertebral artery is underdeveloped and its lumen is narrowed. In total, a person has two vertebral arteries - right and left; they are the largest of the arteries located in the neck and play an important role in supplying blood to the brain. Hypoplasia of one of the arteries may have serious consequences for health, although many patients with this disorder live full lives, can engage in any sports, and perform the same types of work as completely healthy people.

Causes of hypoplasia of the right vertebral artery

Hypoplasia of the right vertebral artery is congenital disorder. The following factors may influence its development:

Smoking during pregnancy;
Alcohol abuse and/or drug use during pregnancy;
Taking certain medications. At this time, it is impossible to say in advance which medications will lead to this disorder in the future;
Some injuries;
Exposure to ionizing radiation, for example, undergoing chemotherapy while pregnant;
Exposure to various toxins, for example, in the workplace of the expectant mother;
Various infectious diseases suffered during pregnancy.

A family history of hypoplasia of the right vertebral artery increases the likelihood of its development in a child. However, it is currently impossible to predict how to prevent the development of hypoplasia of the right vertebral artery. A woman can reduce the likelihood that her baby will develop this or other disorders to some extent by living a healthy lifestyle, taking prenatal vitamins, and carefully following any instructions from her doctor.

Signs of hypoplasia of the right vertebral artery

Although hypoplasia of the right vertebral artery is present in humans from birth, it extremely rarely makes itself felt in childhood. As a rule, people live for many years without knowing that they have such a health problem. This is due to the fact that although the right vertebral artery cannot pass the volume of blood for which it is designed, part of its work is performed by other, smaller arteries.

The consequences of hypoplasia of the right vertebral artery may appear if the patient develops atherosclerosis, osteochondrosis Osteochondrosis - learn to correctly distribute body weight , affecting the spine, as well as with dislocation of the cervical vertebrae and the formation of blood clots in a narrowed blood vessel. Because of this, the blood supply to certain areas of the brain is disrupted, and this can lead to the following symptoms: drowsiness, increased fatigue, weakness of the arms or legs, headaches, numbness of the limbs and, sometimes, other parts of the body, unsteady gait, problems with coordination of movements .

In some cases, sudden mood swings are possible. Are mood swings in women a bad character or an illness? and/or blood pressure. In addition, patients experience symptoms characteristic of the disorders that caused the appearance of signs of hypoplasia.

In general, in the presence of hypoplasia of the right vertebral artery, such common disorders as atherosclerosis and spinal osteochondrosis Spinal osteochondrosis - causes and symptoms of the disease may lead to more serious consequences than usual.

Diagnostics

If hypoplasia of the right vertebral artery is suspected, patients are usually prescribed an ultrasound examination first. This method allows to assess the condition of the blood vessels of the neck to a certain extent, but it is not accurate enough. Patients may require magnetic resonance imaging for further evaluation.

Treatment

In order to prevent the manifestations of hypoplasia, as well as to alleviate its symptoms, patients with this disorder are recommended:

However, these measures are often not enough to cure hypoplasia of the right vertebral artery and avoid it negative consequences for good health. Patients with this disorder may be prescribed medications that improve blood flow to the brain, as well as medications that thin the blood. If conservative treatment hypoplasia of the right vertebral artery will be ineffective and will require surgical operation. To treat hypoplasia, the most commonly used method is stenting.

Stenting is considered a relatively safe operation, although in some cases complications may include: allergic reaction the contrast agent used during surgery, weakening of the artery wall, bleeding, re-blocking of a narrowed artery, and kidney problems. The risk of complications is especially high in patients with diabetes and kidney disease, as well as in patients with thrombosis. To minimize risks, before surgery the patient undergoes an examination and talks with a doctor.

The operation is performed using a catheter, which is inserted into the narrowed artery through a small incision in the skin. The catheter first inserts a small balloon that widens the artery, and then a stent, like a mesh tube, that expands inside the artery. It prevents the lumen of the artery from decreasing, due to which blood flow is normalized. After the stent is inserted, the surgeon performs an examination using a contrast agent to ensure that the stent is positioned correctly.

Currently, stents coated with drugs are sometimes used. They prevent the formation of scar tissue inside the stent, which means they prevent the vertebral artery from being blocked again.

Typically, patients must stay in the hospital for at least six hours after surgery. As a rule, during this time they are recommended to remain in horizontal position. Patients are regularly examined by doctors to identify any complications that might arise after surgery as soon as possible. If you notice any unusual symptoms, such as pain in your legs that lasts for several minutes or gets worse quickly, difficulty breathing, coldness in your extremities, or numbness in any part of your body, tell your doctor right away.

Most patients do not experience any serious problems after stenting and are sent home. In the first days after surgery, it is not recommended to lift objects heavier than three to four kilograms, and also to refrain from very intense physical activity. You should drink a lot during the two days after stenting in order to quickly remove the contrast agent from the body. You can take a shower within 24 hours after surgery, but it is recommended to take a bath no earlier than four to five days later.

Patients must take aspirin or other blood thinners for some time after surgery. In addition, you need to take short walks every day and, sometimes, do exercises recommended by your doctor. Physical activity is one of the ways to avoid the formation of blood clots in blood vessels.

If you feel chills, dizziness, fever, shortness of breath, or other worrying symptoms a few days after surgery, seek medical attention immediately.

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What is the essence of the disease

It is impossible to understand pathology without knowing the norm. The brain receives blood from two large vascular systems: the internal carotid and vertebral arteries. Each of these vessels is paired and brings blood to a specific area of the right or left hemisphere of the brain. Compound final branches these two arteries are called the circle of Velisius. This is a very important anatomical formation that provides compensation for blood flow if one of the main vessels is blocked for some reason. Thus, the brain has the ability to self-regulate its blood flow, protecting itself from oxygen starvation and damage.

The right vertebral artery, as one of the powerful components of the circle of Velisius, departing from the subclavian artery, enters the spinal canal of the transverse processes of the cervical vertebrae and is directed along it into the cranial cavity. At the same time, it makes several strong bends, passing through narrow, inert holes. The area of its branching and blood supply is represented by the structures of the posterior cranial fossa corresponding side (cerebellum, medulla, occipital lobe of the hemispheres).

When talking about hypoplasia of the right vertebral artery, we mean its congenital underdevelopment and narrowing of the diameter. Naturally, under such conditions, the corresponding areas of the brain will be deprived of normal blood supply. If such a pathology is combined with an open Velisian circle, extreme high risk severe ischemic (stroke) brain damage.

Causes of the disease and its manifestations

Hypoplasia of the vertebral arteries is of congenital origin. Unfortunately, it is impossible to foresee and influence its development. A connection has been established between the occurrence of this vascular anomaly and the intrauterine effect on the body of the fetus and the pregnant woman of the following environmental factors:

Ionizing radiation and radiation;
Infections of viral and bacterial origin;
Toxic substances and chemicals;
Drug effects;
Bad habits.

The hereditary factor plays a very important role in the origin of hypoplasia of the vertebral arteries. The presence of this vascular anomaly has been noted in relatives, especially first-degree relatives.

Very rarely, hypoplasia manifests itself in children. It usually makes itself felt in young and middle age. The main provocateurs of cerebral circulation disorders in the initially narrowed vertebral artery can be the following reasons:

Osteochondrosis of the spine, leading to the appearance of bone growths that compress the artery;
Spondylolisthesis and subluxations of the cervical vertebrae, deforming the spinal canal with blood vessels;
Ossification of the vertebral-occipital membrane through which the vertebral artery penetrates into the cranial cavity;
Vascular atherosclerosis;
Formation of blood clots in the lumen of an anomalous artery.

In a child, hypoplasia of the vertebral artery can manifest itself only in the case of its critical narrowing against the background of a disconnected circle of Velisius. In this case, the body is deprived of the ability to compensate for the lack of blood flow through connections of the affected artery with other cerebral vessels.

Vertebral artery hypoplasia is an abnormality of this vessel that a person is born with. But it manifests itself only after some time, when age-related changes in the spine or vascular wall occur. This leads to its critical narrowing with signs of cerebrovascular accident.

Symptoms of the disease

Hypoplasia of the left vertebral artery is not as common as the right one. Therefore, when discussing the clinical manifestations of their damage, attention is primarily focused on damage to the right vertebral artery. Manifestations of decompensated disturbance of blood flow through this vessel are reflected in the table.

General cerebral symptoms	Headache; Dizziness.
Focal symptoms vascular disorders in the hemispheres of the brain	Weakness in left extremities (arm and leg); Numbness and loss of sensitivity; Movement disorders such as mild paresis and paralysis.
Focal symptoms of damage to the occipital lobe of the brain	Decreased visual acuity; Visual hallucinations.
Stem and autonomic reactions	Instability of blood pressure with its strong changes.
Cerebellar disorders	Unsteadiness when walking; Violation of fine movements; Discoordination of movement disorders of the limbs.

Typically, manifestations of hypoplasia of the right vertebral artery develop gradually. These do not have to be all the symptoms listed in the table. The patient can note only some of them, which depends on which part of the brain at a particular moment feels the greatest circulatory deficiency. Symptoms are transient, periodically exacerbating and then subside. This intermittent course masks the true problem under the guise of any other diseases (neurocirculatory dystonia, dyscirculatory encephalopathy, etc.). In case of prolonged uncorrected progression of brain damage symptoms, there is a high risk of developing pre-stroke conditions or even stroke. Therefore, it is extremely important to detect the true problem in time.

Modern diagnostics

The following methods can help make a correct diagnosis:

Ultrasound examination of the vessels of the head and neck. In particular, duplex angioscanning of the vertebral artery along its course in the canal of the cervical spine is indicated. At the same time, its image is obtained, the diameter, type and intensity of blood flow are assessed. The method is used as a screening method, as it is absolutely safe and can be performed under any conditions;
Angiography is a graphical recording of the anatomical structure, features of the course and connections of all vascular formations of the brain. First of all, the vertebral artery is assessed. The study is carried out using special X-ray equipment. In this case, one of the large arteries of the extremities is punctured, a special guide is passed to the branching site of the vertebral artery and contrast is injected into it. Its structure is assessed by external characteristics, which are displayed on the screen in the form of a container filled with contrast;
Contrast-enhanced tomographic examination of the head and neck. Performed on computer or magnetic resonance imaging scanners using injection contrast agents that fill the vessels.

When conducting any of the listed studies, they focus on the actual diameter of the right vertebral artery. Normally it is 3 mm. If there are signs of narrowing of the vessel to two or less millimeters, its hypoplasia is stated.

Treatment

You can help in two ways:

Conservative therapy. This treatment of vertebral artery hypoplasia involves the administration of drugs that improve blood properties, blood supply to the brain and metabolic processes in it. This does not cure the problem, but only protects the brain from critical ischemic changes. For these purposes, trental, actovegin, vinpocetine, ceraxon, cinnarizine, cerebrolysin, thiocetam, blood-thinning drugs are used;
Surgery. It is associated with great difficulties and is used only if it is impossible to compensate for cerebral blood flow in other ways. Modern neurovascular surgeons perform endovascular surgery. Its essence lies in the introduction of a special dilator (stent) into the lumen of the narrowed vertebral artery. It increases the diameter of the pathological section of the artery, restoring normal blood flow. This intervention is performed similarly to the diagnostic procedure - angiography and can be carried out during its implementation.

Treatment of hypoplasia of the right vertebral artery does not always bring the desired results. It all depends on the length of the narrowed area and the presence of connections between different arterial vessels of the brain (circle of Velisius). If it is sufficiently developed, it can compensate for almost any circulatory disturbance.

Treatment of obliterating endarteritis of the lower extremities Aortic valve regurgitation

Currently, ultrasound is one of the accurate, safe and painless methods for diagnosing pathologies of the cervical vessels, which play a very important role in normal operation brain. This diagnostic method is the most optimal in terms of the ratio of information obtained, cost and accessibility for a wide range of patients in comparison with angiography), which, as a rule, is used for clarifying the diagnosis of changes identified by ultrasound.

These are tubular structures that extend throughout our body and transport blood to organs and tissues. Among all the vessels of the body, arteries, arterioles, capillaries, venules and veins are distinguished.
Arteries are called large vessels, according to which blood is flowing from the heart to other organs and parts of the body. They have a muscular membrane or elastic fibers in their structure, therefore they are very flexible and can shrink or expand depending on the volume of blood flowing through them.

Vessels of the neck and head

The arteries then divide into smaller diameter arterioles, which are also quite elastic.
Capillaries are the thinnest vessels located inside organs and tissues through which exchange takes place. necessary substances between blood and cells. The diameter of the capillaries is tenths of a millimeter. After leaving the intercellular space, the capillaries unite into larger vessels - venules.

Following the venules are even more large vessels– veins. They carry blood from organs and tissues back to the heart. The walls of the veins are thinner than those of the arteries and are not as elastic; they are easily compressed when pressed. But many veins have special valves that prevent blood from flowing back into them.
With help you can examine arteries and veins with a diameter of 1-2 millimeters.

What vessels look on the neck and why?

During an ultrasound scan of the vessels of the neck, the doctor must carry out:

brachiocephalic trunk;
right and left subclavian arteries;
right and left common carotid arteries;
right and left internal carotid arteries;
right and left external carotid arteries;
vertebral arteries.

If necessary, the following can be additionally examined:

jugular veins;
veins of the vertebral plexus;
supratrochlear arteries;
ophthalmic arteries.

All of the above vessels are examined for the possible detection of the following pathologies:

Atherosclerosis of extracranial arteries. It is possible to establish not only pronounced atherosclerotic changes, localization and size of plaques, degree of stenosis, complications, but also initial manifestations atherosclerotic lesions of the carotid arteries in the form of thickening of the intima-media complex. In the presence of significant stenoses and vascular occlusions, the performance of cervical anastomoses, that is, bypass paths of blood flow, is assessed.
Nonspecific aortoarteritis or Takayasu's disease. Using ultrasound, the doctor can distinguish aortoarteritis from atherosclerotic lesions and give a detailed description of blood flow disorders.
Dissection. Using ultrasound, you can identify signs of dissection of the arterial wall during thrombosis with unknown reason or after injury.
Arterial deformations. Ultrasound quite accurately shows the presence, shape and location of deformations of the examined arteries, as well as the effect of the identified deformations on blood flow.
Steele syndrome or vertebral-subclavian steal syndrome. Ultrasound helps to establish the location of the lesion, the degree of narrowing of the artery, and the characteristics of hemodynamic disturbances in it.
External compression of blood vessels by neighboring organs and tissues.
Congenital anomalies of vascular development and their effect on the blood supply to the brain.
Disturbances in the venous outflow of blood from the brain. Ultrasound helps to identify the signs and causes of this pathology.

But the main purpose of conducting an ultrasound examination of the extracranial arteries of the neck is to identify possible reasons and further prevention of the development of a dangerous disease - cerebral ischemic stroke.

Who is indicated for ultrasound of the extracranial brachiocephalic vessels?

Ultrasound of the vessels supplying blood to the brain, located in the neck, is prescribed for the following complaints: headaches, dizziness, periodic disturbances of vision, memory, movement, speech, ringing in the ears, surges in blood pressure, loss of consciousness.

This study is also recommended to be periodically performed by all persons over 45 years of age to identify initial changes in the vascular wall, patients suffering from diabetes mellitus, metabolic syndrome, hypertension, having had a stroke or transient ischemic attack, myocardial infarction, after surgery on the vessels of the head and neck.

What can an ultrasound scan of the cervical vessels show?

An ultrasound examination shows the doctor whether there are any obstructions in the vessels of the neck that are preventing normal blood flow. In this case, it is possible to accurately measure how narrowed the lumen of the affected part of the vessel is and to what extent. They also determine how firmly the plaque or thrombus is attached to the vessel wall, and whether there is a high risk of its rupture. You can clearly examine the condition of the walls of the blood vessels, whether there are any defects in them.

Ultrasound diagnostics quite reliably determines anomalies in the course of blood vessels and their deformations. In addition, when conducting a modern comprehensive ultrasound examination, the maximum and minimum blood flow speed, resistance indices and other parameters necessary to assess the sufficiency of blood supply to organs and tissues are assessed.

Interpretation of the ultrasound report of the vessels of the cervical spine

A typical neck protocol describes:

patency of all examined vessels,
thickness of the intima-media complex in the CCA and PGS,
condition of the vascular wall,
course and deformation of blood vessels,
if there are lumen disturbances, then describe in detail the size of the stenosis, its effect on blood flow,
diameter of the vertebral arteries,
type of blood flow in the artery,
speed indicators and resistance indices in the common carotid, internal carotid, vertebral and subclavian arteries,
condition of the jugular and vertebral veins.

Must be completely passable and go straight. In the vessel wall, the inner and middle layers should be clearly distinguishable, which are visualized as hyperechoic and hypoechoic parallel stripes. They are used to measure the thickness of the intima-media complex. In healthy vessels, IMT in the PGS should not exceed 0.12 cm, and in the CCA 0.10 cm. Large size intima-media indicates the initial signs of vascular atherosclerosis. If IMT is more than 0.15 cm, then this is already considered an atherosclerotic plaque. If it is detected, the ultrasound transcript necessarily contains the structure of the plaque, its extent, the degree of narrowing of the vessel lumen and the hemodynamic significance of the stenosis.

The diameter of paired vessels is assessed - it should not be very different. Important role The diameter of the vertebral arteries plays a role in the blood supply to the brain. It is considered normal at a size of 3.0 to 4.0 mm. Arteries with a diameter of 2.0 to 2.9 mm are considered a developmental variant, and those less than 2.0 mm are called hypoplasia. If the diameter is from 4.1 to 4.9 mm, then this is also an acceptable development option. But if the diameter of the vertebral artery on any side is more than 5.0 mm, then this is considered a pathological expansion.

In addition to assessing anatomical and morphological features neck arteries, the ultrasound protocol includes blood flow parameters, such as maximum systolic velocity, minimum diastolic velocity and the ratio of these velocities in the form of resistance indices. Changes in these parameters throughout the course of the vessel are assessed if there are deformations, stenoses or occlusions.

Jugular veins in a transverse section normally have oval shape and compress easily with slight pressure. If they are not compressed, this indicates the presence of a blood clot in their lumen. Valves can be seen in the lumen of the veins.

The normal course of veins, like arteries, should be straight, the diameter uniform throughout. The diameter of the jugular veins should normally not be greater than triple the diameter of the corresponding carotid artery. The diameter of the vertebral veins is normally no more than 2.5 mm. The blood flow in the veins of the neck must be synchronized with the act of breathing. The maximum velocity in the vertebral vein should not exceed 30 cm/s.

Ultrasound signs of the main detected pathologies

Atherosclerotic lesion of the vessels of the neck

The main causes of vascular obstruction are most often atherosclerosis or thrombosis. They lead to stenosis or occlusion of the lumen of the vessel. Stenosis is an incomplete narrowing of the lumen. Occlusion is a complete blockage of the lumen of a vessel in any area, as a result of which blood cannot flow further. In the neck, atherosclerotic plaques most often form in the area of the bifurcation of the common carotid artery, the mouth of the vertebral artery, the siphon of the internal carotid artery, and the mouth of the subclavian artery. Doctors know these features, and therefore Special attention devote attention to examining these particular places.

Carotid artery stenosis on ultrasound

The initial manifestations of atherosclerosis are characterized by an increase in the thickness of the intima-media complex from 1.0 to 1.5 mm. If the thickness of these layers is more than 1.5 mm, then they already talk about a plaque. During an ultrasound examination, the plaque may look completely different on the screen. They can be homogeneous and heterogeneous, hyperechoic, and isoechoic. The most unfavorable are considered to be atherosclerotic plaques that are heterogeneous in structure and have an uneven surface. They are at high risk of complications.

In case of stenotic lesion of the artery, the doctor measures the degree of narrowing of the vessel on a longitudinal or transverse section of the vessel, and measures the extent of the lesion. Plaques up to 1.5 cm in length are considered local, and longer ones are considered prolonged. This parameter is extremely necessary for assessing the significance of lesions and planning treatment tactics.

Arterial thrombosis

Arterial thrombosis differs from atherosclerosis, as a rule, by the following ultrasound signs:

occlusion predominates more than stenosis,
the lesion is longer in length,
more often the echogenicity of intraluminal formations is relatively homogeneous, the echogenicity varies depending on the stage of thrombosis,
in the area of the beginning of occlusion - the surface is flat,
with prolonged existence of thrombosis, hypoplasia of the artery develops.

Arterial deformities

Deformities are the second most common changes after atherosclerosis. They can be congenital or acquired. In children under 18 years of age, deformities are considered normal. Children are born with a short neck, and the vessels have the same length as those of adults, and in order for them to “fit” in the neck, they have different bends and deformations. As the neck itself grows, the vessels align and acquire a straight course. In older people, under the influence of changes in blood pressure, the vessels stretch and can become tortuous again.
The following types of deformations are distinguished by shape:

tortuosity is a deformation with an angle greater than 90 degrees, they are C- and S-shaped;
bends - deformations with an angle of 90 degrees or less; they have the worst effect on blood flow, as they lead to a narrowing of the lumen at the point of bend;
loops are circular configurations of the artery, often congenital.

During an ultrasound examination, as a rule, the course of the vessel is clearly visible, and it is not difficult for the doctor to determine the type of deformation, its location, and the size of the angle.

Nonspecific aortoartery disease (Takayasu disease)

Unlike atherosclerosis, which affects more men, Takayasu's disease is more common in young women. Main ultrasonic sign lesions of the carotid arteries are uneven, diffuse, hyperechoic thickening of the wall of the common carotid artery. Moreover, unlike atherosclerosis, the thickening is circular in nature, that is, it affects all the walls of the vessel. It becomes difficult to distinguish the individual layers in the wall.

Metabolic angiopathy

Metabolic angiopathy is a complex structural changes in the vascular wall of arteries caused by various metabolic disorders. Most often occurs in patients with diabetes. In this case, small ones are visible in the wall of the vessel. Changes in the spectral characteristics of blood flow are characteristic: an increase in resistance indices is detected in the proximal part of the artery, a decrease in velocity in the distal part.

Arterial dissection

Dissection is called local separation of the wall as a result of its tear. Most often it occurs due to injury. At the site of dissection, detachment of the upper layer of the vascular wall occurs, blood begins to get under it and thrombose, forming a hematoma. During an ultrasound examination, the doctor sees a dissected wall with movable intima or the presence of a second lumen of a vessel with blood flow.

Cerebral venous circulation

There can be many reasons for the violation. During an ultrasound examination, the transcript may contain the following criteria indicating stagnation of venous blood in the brain:

an increase in the diameter of the internal jugular vein (more than three times the diameter of the common carotid artery) as a result of compression in the proximal parts or valve insufficiency,
reduced diameter of the internal jugular vein as a result of congenital hypoplasia or compression,
bidirectional flow (reflux) in the vein as a result of valve insufficiency,
increase in blood flow speed in the internal jugular vein more than 70 cm/s, in the vertebral column – 30 cm/s,
lack of blood flow in the internal jugular vein (thrombosis),
an increase in the diameter of the lumen of the vertebral vein by more than 2.5 mm in the spinal canal,
compression of the vertebral vein: its uneven diameter, arched course or acceleration of blood flow at the site of compression.

Conclusion

Ultrasound examination of neck vessels is important method diagnostics, which makes it possible to completely painlessly identify significant ones in a short time. This study helps to establish in time, and when prescribing adequate subsequent treatment, to prevent disruption of the blood supply in one of the most important organs human body - the brain.

The etiological factors of the pathology of the vertebral artery (VA) are: 1 - occlusive diseases of the arteries (atherosclerosis, thrombosis, embolism, arteritis of various origins); 2 - extravasal compression of the arteries (compression by bone anomalies, ribs, muscles, osteophytes and articular processes of the cervical vertebrae, scars, tumors, etc.); 3 - arterial deformations (: types of pathological tortuosity of arteries).

More about PA deformations . The following types of PA deformations are distinguished: elongation, tortuosity, kinks, as well as looping and spiral torsion. Tortuosity and kinks are of greatest importance for the clinic (approximately 1/3 of the cases among all deformities), since they lead to temporary or permanent disruption of the patency of the arteries with the formation of septal stenosis. According to N.V. Vereshchagin, VA kinks are detected at autopsy in 33% of patients with cerebrovascular accident. They, as a rule, are selectively localized in the V3 segment, which is less often and less affected by atherosclerosis than others [ read about PA segments]. In 20% of patients with pathology of the vertebrobasilar system of the VA, the following are found: aplasia or hypoplasia of the VA (hypoplasia of one of the arteries is observed in approximately 5 - 10% of cases, aplasia - in 3%); high entry of arteries into the bone canal (in 10.5% of cases at the level of C3 - C4 - C5), anomalies in the origin of the VA (with lateral displacement of the VA orifice). S. Powers et al. described a new syndrome - intermittent compression of the VA (3 - 4% of cases) with the VA originating from the posterior surface of the subclavian artery and a rare double-root variant of the VA originating from the aortic arch and the left subclavian artery (2% of cases).

More about PA hypoplasia . VA hypoplasia is a decrease in the internal diameter of the artery by less than 2 mm (however, there is no uniform agreement regarding the diameter of the vessel, and in some studies a decrease in the outer diameter of the VA by less than 3 mm was considered a sign of VA hypoplasia). The contralateral hypoplastic VA is usually called the dominant artery. In the literature, VA hypoplasia is considered as a manifestation of undifferentiated dysplasia connective tissue, developing as a result of various hereditary forms damage to connective tissue (however, there is no data on its frequency in people with hereditary pathology of connective tissue), or as a consequence of the impact of various unfavorable factors on the fetus during its intrauterine development, which leads to a defect in the formation of the connective tissue framework of the vascular wall (PA hypoplasia of acquired origin). ! PA hypoplasia, alone or in combination with pathological deformities and/or tortuosity of the internal carotid artery, may be one of the risk factors for the development of circulatory disorders in the vertebrobasilar system.

Methods for detecting PA pathology are : ultrasound (ultrasound), magnetic resonance angiography (MRA), CT angiography (CTA: computed tomography + angiography), etc., for example, there are studies devoted to the study of the morphometric parameters of the horizontal part of the VA in the atlanto-occipital sinus using a spiral computed tomography(SKT).

The advantage of ultrasound examination is non-invasiveness and safety of the examination. However, ultrasound techniques require high skill and correct execution of the study. Ultrasound Dopplerography (USDG; if ultrasound Dopplerography is used to study the intracranial part of the artery, then it is called TCDG - transcranial Dopplerography) in its pure form allows only indirect assessment of the state of cerebral blood flow. Ultrasound (duplex) scanning makes it possible to detect with a high degree of reliability existing circulatory disorders in the extra- and intracranial parts of the VA. The method makes it possible to visualize the VA mainly in its second (V2) segment (at the level of the transverse processes of the cervical vertebrae), where its vertebrogenic compression is observed. Normally, duplex ultrasound scanning (B-mode) visualizes the straight trunk of the VA. In a standard study, linear sensors with a frequency of 7.5 MHz are used, scanning along the front and side surfaces of the neck. In this case, a qualitative and quantitative (spectral analysis) assessment of blood flow in the vessels is carried out. Qualitative analysis includes assessment of the diameter (the norm is 2.8 - 3.8 mm) and the shape of the vessel (presence of bends, loops, etc.: with vertebrogenic compression of the VA in B-mode, an arcuate displacement of the VA above the osteophyte can be visualized [see at the beginning of the paragraph ] (in some cases, visualization of a local decrease in artery diameter is also possible).

The possibility of duplex scanning is also the assessment of the spectral characteristics of blood flow in the VA and the calculation of quantitative indicators of blood flow. When performing a standard spectral analysis of the vertebral arteries, they measure (most often in the interval between V and VI cervical vertebrae) systolic (norm – 31-51 cm/s), average (norm – 15-26 cm/s), diastolic (norm – 9 – 16 cm/s) and volumetric (norm 60-125 ml/min) linear blood flow velocity (LSC), as well as pulse (normal - 1.1 - 2.0) and resistance (normal - 0.63 - 0.77) impulses. Ultrasound examination of the vertebrae is also performed at the level of the CI and CVII vertebrae. It should be noted that the concept normal speed blood flow for the vertebral (and carotid) arteries is somewhat arbitrary, because it is impossible to accurately determine the angle of the artery location. However, based on large quantity Studies (including foreign ones) have established that the error in measuring the angle fluctuates within 5% (the normal values of the average LSC for the vertebral arteries fluctuate depending on age and range from 11 to 19 cm/s).

In addition, the advantage of ultrasound duplex scanning (including in pediatric practice) is also the possibility of performing functional (positional) tests with rotation or tilting of the head, which allows us to identify the presence of not only static, but also “hidden” compression of the vertebral arteries. Also, functional tests can be recommended as a screening test, both to determine the scope of further examination of the patient and to identify risk groups for the development of cerebral circulation disorders in the vertebrobasilar region (it is also advisable to use these tests as a means of monitoring the restoration of blood flow during treatment, as the most available method diagnostics). However, according to Nikitin Yu.M. and Trukhanova A.I. (2004) the idea of individual doctors that changes in the vertebral artery BSC parameters when turning the head to the sides serves as a sign of functional compression of the VA or its stenosis is deeply erroneous. In these cases, changes in the linear velocity of blood flow (LVR) are caused only by a change in the angle of location of the vertebral artery, which occurs when turning the head, and not by the appearance of functional stenosis or closure of the lumen of the artery. Attempts to prove the possibility of vertebrogenic compression of the VA during movements in the cervical spine are, as a rule, methodologically untenable.

In the last decade, triplex Dopplerography has begun to be used, which allows for three-dimensional reconstruction of any vessel in “real time” (with triplex Dopplerography, three Dopplerography methods are used simultaneously: B-mode, color Dopplerography and pulsed wave Dopplerography). Modern devices for ultrasound diagnostics of the highest and expert class, they allow you to visualize vessels with a diameter of less than 1 mm, determine pathological changes in them or surrounding tissues. This is very important when examining patients with PA pathology.

Further diagnosis of lesions of the vertebral arteries according to data national recommendations on the management of patients with vascular arterial pathology (Russian consensus document) “Part 3. Brachiocephalic arteries” [Russian Society of Angiologists and Vascular Surgeons Association cardiovascular surgeons Moscow, 2012]:

Symptoms of vertebrobasilar insufficiency (VBI) are not specific. They can be a manifestation of many other diseases, and therefore, diagnosing VA lesions requires a thorough study of the patient’s complaints and medical history, as well as physical and instrumental examination.

Screening instrumental methods for identifying VA lesions are ultrasound dopplerography, TCD and CDG (color duplex scanning). In fact, the only ultrasound criterion for VA occlusion is the absence of blood flow at the location. Stenotic lesions of the VA can be suspected when the asymmetry of the average blood flow velocity is more than 30% (for unilateral lesions). A decrease in the average blood flow velocity to 2 - 10 cm/s undoubtedly indicates the presence of VA stenosis. If with unilateral stenosis both criteria can be taken into account (asymmetry of blood flow and a decrease in its average speed), then with bilateral stenosis one has to focus only on absolute indicators of blood flow speed. When stenosis of one VA is combined with occlusion of the other, the diagnosis of stenosis becomes even less reliable due to a compensatory increase in blood flow through the stenotic VA. Currently, as a result of the use of CDS, the accuracy of determining VA lesions has increased significantly and is 93%.

To determine the degree of compensation of blood flow in the VBB and carry out differential diagnosis, otoneurological research can be used in combination with electrophysiological data on auditory evoked potentials, characterizing the state of brain stem structures, as well as determining the photomotor reactivity index.

Indirect data on the vertebrogenic effect on PA can also be obtained from conventional radiography of the cervical spine, performed with functional tests.

To clarify the cause of VBI, diagnostic methods such as CT and MRI can be used; MRA (MR angiography) is an extremely valuable method for diagnosing lesions main arteries heads. However, in contrast to the literature on carotid artery imaging, data published on noninvasive VA imaging are extremely sparse and controversial. The systematic review identified 11 studies examining non-invasive imaging of VA. CTA and MRA showed more high sensitivity(94%) and specificity (95%) than the use of DS (sensitivity 70%), and CTA had greater reliability. Technical difficulties in performing DS make this method less informative when studying diseases of a given anatomical region. Considering the fact that it is not always possible to clearly visualize the VA orifice with either MRA or CTA, the use of radiocontrast angiography in patients with symptoms of VBD before revascularization is necessary. X-ray contrast angiography is indicated only in the presence of symptoms of VBI and damage to the vertebral arteries proven using non-invasive research methods. Digital subtraction angiography with contrast can be useful when selective catheterization of the VA is not feasible, but the accuracy of this method is comparable to CTA.

Additional Information:

1 . [read] article “Possibilities of ultrasound diagnostics in vertebral artery syndrome” Safronova O.A., Nenarochnov S.V., Morozov V.V.; Center for new medical technologies Institute of Chemical Biology and Fundamental Medicine, Siberian Branch of the Russian Academy of Sciences, Novosibirsk; magazine " Basic Research"No. 10, 2011;

2 . [read] article “Comparative assessment instrumental methods studies of the vertebral artery" I.V. Andreeva N.V. Kalina, Lugansk State medical University, Ukraine; Scientific bulletins, series “Medicine. Pharmacy" 2013, No. 18 (161), issue 23;

3 . [read] lecture " Modern aspects diagnosis of anomalies and deformations of the vertebral artery" L.P. Metelina, N.V. Vereshchagin; State Research Institute of Neurology, Russian Academy of Medical Sciences, Moscow; Journal "Neurosurgery" No. 4, 2005;

4 . [read] article “Anatomical and physiological prerequisites for the development of vertebral artery syndrome” by A.V. Logvinenko, Kharkov medical Academy postgraduate education, Ukraine (International Medical Journal, No. 4, 2016)

One of the most serious birth defects is hypoplasia of the right vertebral artery. If treatment of the disease is delayed, it can lead to poor circulation, dysfunction of the circulatory system and heart function.

Hypoplasia to one degree or another is diagnosed in approximately ten percent of the world's population.

Total information

Correct blood circulation in each of the body systems is ensured only by the Circle of Willis, formed from the left and right spinal arteries.

If there is no development of a pathological process, then both arteries develop consistently well.

Hypoplasia of the vertebral arteries can be congenital or acquired. Left-sided hypoplasia is less common than right-sided hypoplasia. Sometimes, due to the depletion of the adaptive abilities of the human body, there is a need for surgical intervention.

Development factors

Hypoplasia of the vertebral artery develops due to a number of factors. Some of them affect the human body even when it is inside the mother’s womb.

Hypoplasia occurs for reasons such as:

injuries during pregnancy;
use alcoholic drinks, strong drugs, narcotic drugs, as well as smoking;
development of infection during pregnancy;
genetic predisposition.

Disease of the left and right vertebral arteries can be caused by other reasons. Modern doctors do not yet have a consensus on this issue.

Consequences

This disease can have quite serious consequences. Thus, due to strong compression of the artery, the flow of blood to the brain tissue is significantly hampered. Unfortunately, to establish the exact cause pathological processes It doesn't always work out. Despite this, doctors are confident that the maximum that can threaten a person is such consequences as high fatigue, decreased hearing and visual acuity, as well as the appearance of severe headaches.

Sometimes the disease “sleeps” for a considerable number of years. If its symptoms are non-aggressive, then circulatory disorders are explained by the development of other pathological processes.

Symptoms

Hypoplasia of the right vertebral artery “increases” symptoms quite slowly. This is why diagnosing the defect is problematic.

The most common symptoms are:

headaches and dizziness;
decreased sensitivity in some areas of the body;
dysfunction of the vestibular apparatus;
drowsiness and fatigue;
mood swings;
increased blood pressure.

One of the key functions of the right vertebral artery is to “feed” the brain. Over time, vessels that have lost their elasticity and become heavily clogged provoke a narrowing of the lumen of the right vertebral artery.

The picture of the development of the disease will become clearer with the age of the patient. Due to some age-related changes, hypoplasia of the right vertebral artery can provoke the development of atherosclerosis.

Hypoplasia of the left vertebral artery may also not appear for a considerable amount of time. Characteristic symptoms Pathologies of the left vertebral artery arise against the background of increasing hemodynamic disturbances.

Signs of a violation of the left vertebral artery are:

development of vascular connections (anastomoses);
pain in the cervical spine;
the occurrence of arterial hypertension (increased blood pressure)

Disruption of the left vertebral artery can provoke the development of arterial hypertension.

Alarming symptoms should be a reason to promptly consult a doctor.

Diagnostics

Disorders of the right and left vertebral arteries can be recognized already at the first appointment with a professional neurologist. The doctor is based primarily on the patient’s complaints, and, after a preliminary diagnosis, refers the patient to an ultrasound scan of the vertebral artery.

Hypoplasia is diagnosed when there is a narrowing of the vascular lumens to two millimeters. In order to finally verify the presence of dysfunction of the left and right vertebral arteries, angiography is performed to reveal the real condition of the vessels. After this, the doctor prescribes appropriate treatment.

Treatment of hypoplasia

It’s paradoxical, but true: in most cases, due to the adaptive characteristics of the human body, which perfectly cope with circulatory disorders, treatment of the disease is not required.

But if disorders of the left vertebral artery or right vertebral artery make a person anxious, then one should not delay visiting a doctor.

Treatment should be started as quickly as possible, because otherwise, the doctor will be forced to resort to surgery.

Operation

Surgical treatment of the right and left vertebral arteries includes:

angioplasty (opening an artery using a special catheter);
stenting (expansion of a narrowing vessel using a stent).

Treatment through surgical intervention is possible only if the disease has become severe.

Drug therapy

Most often, the doctor prescribes treatment with drugs that lower blood pressure and dilate blood vessels.

Hypoplasia is treated by increasing blood flow. In most cases, the patient is prescribed drugs such as Cavinton and Betaserc.

Other procedures

Treatment of a disease such as hypoplasia allows the patient to attend the following procedures:

massage;
acupuncture;
gymnastic therapy.

Prevention

Treatment of such a serious disease as hypoplasia would be incomplete without taking a number of preventive measures.

In order to protect yourself from relapse, it is recommended to lead an active lifestyle - spend less time at the computer and more time in the fresh air. You should also review your diet and eliminate foods that increase cholesterol levels.