Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery

Modern foreign experience of study of vertebral-basilar insufficiency: clinical manifestations and diagnostic challenges

Authors: M.V. Shumilina 1, E.V. Emets 2

1Bakoulev National Medical Research Center for Cardiovascular Surgery, Ministry of Health of the Russian Federation, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation
2Voronezh Regional Clinical Hospital No 1, Moskovskiy prospekt, 151, Voronezh, 394066, Russian Federation

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UDC: 616.133.33-005-07

Link: Clinical Physiology of Blood Circulaiton. 2018; 15 (2): 75-82

Quote as: Shumilina M.V., Emets E.V. Modern foreign experience of study of vertebral-basilar insufficiency: clinical manifestations and diagnostic challenges. Klinicheskaya Fiziologiya Krovoobrashcheniya (Clinical Physiology of Circulation, Russian journal). 2018; 15 (2): 75–82 (in Russ.). DOI: 10.24022/1814-6910-2018-15-2-75-82

Received / Accepted:  05.02.2018/08.02.2018

Full text:  


In the present review, the opinion of foreign colleagues to the problem of vertebral-basilar insufficiency, the causes of its development and peculiarities of clinical manifestations and diagnostic priorities. It is believed that the most common cause of vertebral-basilar insufficiency is atherosclerosis of the vertebral arteries, and then embolism and dissection of the artery walls. More rare reasons are called migraine, fibrosal dysplasia, coagulopathy and drug abuse. Extravascular compression of vertebral arteries of pathologically changed cervical vertebrae is considered a rare observation. Cases of congenital extravascular compression of vertebral artery in adults, unlike children abroad are registered very rarely. In the available foreign literature there are no data on the role of violations of cerebral venous outflow of arteriovenous imbalance and flavovirens in the development of the vertebral-basilar insufficiency. The main diagnostic criterion is the reduction of blood flow velocity in the vertebral artery.
According to our center in the first place in frequency of pathology of the vertebral artery are ekstravasal compression in 1 segment and septal stenosis in the reserve loops on the second – hypoplasia, tortuosity and stenosis in the proximal, 3 – occlusion and the defeat in the 2nd segment. A significant role is played by disorders of the venous outflow. With increasing venous pressure is disturbed arteriovenous balance with the fall in perfusion pressure and ischemia in the more compromised the pool of the brain. That is why a decisive role in the diagnosis plays a complex ultrasound examination not only of the arteries with functional tests, but also of veins with a measurement of systemic arterial and venous pressures.


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About Authors

Shumilina Margarita Vladimirovna, Dr. Med. Sc., Head of the Group of Ultrasound Studies of Cardiovascular and Organ Pathology, Doctor of Ultrasonic Diagnostics;
Emets Ekaterina Viktorovna, Doctor of Functional Diagnostics

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