Correlations of Arterial Hemodynamics with the Severity of Clinical Manifestations of Vertebrobasilar Insufficiency

Abstract

A variety of clinical manifestations of vertebrobasilar insufficiency in virtually the same anatomical disorders of the vertebral arteries indicates the multilevel regulation of the cerebral bloodflow aimed at its stabilization and maintenance. The main arteries of the head and peripheral arteries were studied by Doppler ultrasonography in patients with anatomical disorders of vertebral arteries (atherosclerotic, extravasal compressions, congenital abnormalities, etc.). A relationship between the variability of clinical picture of vertebrobasilar insufficiency and the diastolic bloodflow in the large aortic arteries was detected.

Low Vertebrobasilar Velocity Is Associated with a Higher Risk of Posterior Circulation Ischemic Lesions

“…The unique anatomical structure of the VB arteries, which originate from two small arteries and connect to a larger one, are different from the internal carotid artery system. Therefore, Spencer’s curve theory might need to be adjusted for this condition [ 20 , 21 ]. Series studies suggest that either unilateral or bilateral vertebral hypoplasia is associated with a higher risk of POCI or VBI [ 22 , 23 ].…”

“…Therefore, using a high velocity criterion for VBI diagnosis might result in inadequate patient inclusion and statistical values. From the perspective of pathophysiology, in the group with high velocity, it might indicate some structural abnormality; compensatory high velocity may ensure adequate blood supply to brain tissues [ 18 , 21 ]; however, in groups with low velocity, it usually means a poor perfusion reservoir and higher risk for ischemia [ 4 , 19 ]. This might explain why there were not as many incidences of stroke in the high-velocity group compared to the low-velocity group.…”