Syndrome of the vertebral artery
Contents:
- Clinical picture of pathology
- Diagnostic measures
- Medical tactic
Syndrome of the vertebral artery( SPA) is still leading in the pathology of vascular diseases of the brain. The term is complex, includes the sum of vegetative, cerebral and vascular syndromes, the cause of which is the violation of sympathetic innervation of the periarterial plexus or a change in the shape of the vessel itself. Among the causes of the syndrome of the vertebral artery, there are such factors:
- vessel occlusion( atherosclerosis, inflammation of the arterial walls, thromboembolism);
- change in shape, lumen( structural deviations, bends, non-physiological curvature);
- compression of the artery from the outside( osteophytes, tumors, articular surfaces, muscles).
Symptoms typical for vertebral artery syndrome often occur in patients with cervical spine pathology. When symptoms of the vertebral artery syndrome appear, treatment to the neurologist is necessary and treatment is mandatory.
In the mechanism of the emergence of the SPA plays an important role in the compression of the artery trunk from the outside and the intertwining of the sympathetic nerves, which leads to spasm of the vessel reflexively, narrowing the lumen, leading to a decrease in blood flow to the posterior regions of the brain and chronic circulatory disturbance. In addition to mechanical compression in the development of the syndrome of compression of the vertebral artery, irritation of the sympathetic plexus located periarterially may occur.
Clinical picture of the pathology of
All signs of vertebral artery syndrome can be divided into the following stages - functional and organic, depending on the presence or absence of morphological pathology in the brain tissue. Functional stage is expressed by three main manifestations:
- impairment of visual function( double vision - diplopia, darkening, spark in eyes);
- vestibular changes( dizziness, instability of gait);
- cephalgia in conjunction with vestibular disorders( pain extends from the occipital to the frontal lobe and is enhanced by head movements).
Paroxysmal headache may disturb a patient at all times. Often pain can be given to the nose region. At inclinations and turns of a head patients complain of a burning sensation. Symptoms may include ringing in the ears, dizziness, nausea, impaired swallowing.
With a long-term current illness, ischemia begins to appear in the brain over time, which indicates the transition of the disease to the organic stage. In this period, the patient manifests as cerebral and focal symptomatology, the manifestation of which can have a transient character and intensify with sharp inclinations or turns of the head.
Diagnostic measures
What to do with vertebral artery syndrome? Due to the variety of manifestations of the disease, not only in different patients, but also in the same patient, its diagnosis does not have a certain algorithm. All checks depend on the prevailing symptom complex. For the diagnosis, the following criteria are necessary:
- is an obvious symptom in a physical examination or in the collection of complaints;
- signs of pathology on MRI or CT, X-ray of the cervical spine;
- signs of disorders in Doppler diagnostics of vertebral vessels with or without load. Under the load means light exercises - bending, turning, extension.
Medical tactic
Certainly, treatment of the vertebral artery syndrome requires comprehensive care of the patient at an early stage to prevent the transition to the organic stage of the disease. Rarely, when an early "blurred" symptomatology is addressed directly to the neurologist. More often the first link is a family doctor or therapist. It is important to recognize the beginning disease and explain to the patient about this disease, the prognosis and how to treat the spinal artery syndrome.
An important role is played by etiopathogenetic treatment - aimed at the cause of the development of the syndrome and the mechanism of its appearance. Drug treatment has the following objectives and includes:
- decreased perivascular edema and inflammatory process( Celecoxib, Nimesulide, Lornoxicam);
- normalization of cerebral blood flow( Pentoxifylline, Winkamine);
- protection from the effect of damaging factors on neurons;
- metabolic therapy.
A major role, of course, is the surgical method of treatment. In the recovery period, it is necessary to perform exercises with vertebral artery syndrome, which will prevent the squeezing of vessels and the development of the clinic, as well as various methods of physiotherapy. Finally it is worthwhile to say that vascular diseases in the far-away prognosis are dangerous, if the appropriate treatment is not taken.
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