What causes basilar artery sclerosis?

Basilar artery sclerosis is a relatively common physical disease, which generally occurs in the human vertebral artery. It is more common in middle-aged and elderly people. Lesions occur in the vertebral bodies and brain parts of the human body, resulting in insufficient blood supply to the blood vessels in the parts, causing brain diseases. It can also endanger illness and lead to heart disease. It is caused by long-term damage to the human vertebral bodies or fatigue.

Causes

The vertebral artery arises from the subclavian arteries on both sides, ascends in the transverse foramina of the 6th to 1st cervical vertebrae, enters the skull through the foramen magnum, merges into the basilar artery at the lower edge of the pons, and divides into the left and right posterior cerebral arteries in the midbrain. The vertebral basilar artery has many branches in the skull, and its blood supply area includes the cranial nerves in the brainstem, ascending and descending conduction bundles, auditory vestibular organs, temporal lobe, occipital lobe and thalamus. When blood supply is insufficient, complex clinical symptoms will appear, and they vary depending on the location, degree, and collateral circulation of the damage. The causes are mostly cervical spondylosis, cerebral atherosclerosis, hypotension, cerebral arteritis, twisting of large blood vessels in the neck, heart disease, vascular malformations, hypercoagulable state, subclavian artery steal syndrome, etc.

Clinical manifestations

Dizziness, nausea and vomiting, unsteady walking, blurred vision, diplopia, monocular and ipsilateral visual field loss, slurred speech, fainting or falls, numbness of the face and limbs, abnormal sensations, etc. may occur.

examine

1. Cervical spine X-ray

It includes anteroposterior, lateral, oblique and hyperextension positions to determine whether the patient has abnormal changes such as cervical spondylosis, intervertebral space stenosis, cervical disc herniation, etc.

2. Transcranial Doppler ultrasound (TCD)

By detecting the vertebral artery and basilar artery through the occipital window based on its spectral image, mean blood flow velocity (vm), pulsatility index and other indicators, the hemodynamic conditions of the vertebral basilar artery and its main branches can be clearly determined, and whether the lumen is narrowed or spasmodic can be inferred, providing evidence for the diagnosis of vertebral basilar artery insufficiency.

3. Brainstem Auditory Evoked Potential (BAEP)

It has definite value in the diagnosis of vertebral basilar artery insufficiency.

diagnosis

The diagnosis can be made based on the cause, clinical manifestations and laboratory tests.

treat

1. Treatment during acute attack

During the acute attack period, there is often severe dizziness, accompanied by nausea, vomiting, unstable standing and other symptoms. Symptomatic treatment such as anti-dizziness should be given as soon as possible. Generally, comprehensive measures are taken, mainly intramuscular or intravenous injection of drugs, and reducing oral medication.

2. Improve cerebral ischemia and hypoxia and regulate brain metabolic function

In addition to the use of blood dilution therapy, cerebral vasodilators, calcium channel antagonists, ginkgo leaf preparations, antiplatelet aggregation drugs and other treatments, brain cell activators can also be used, such as piracetam (Neofukang), pyritinol (Neofuxin), γ-aminobutyric acid, and hydroergoline preparations. Hyperbaric oxygen therapy can be used, which has a certain effect in relieving vertebral basilar artery insufficiency. Studies have shown that extracorporeal counterpulsation, helium-neon laser irradiation therapy and ultraviolet irradiation oxygenated autohemotransfusion therapy have certain therapeutic effects.

3. Etiological treatment

Better therapeutic effects can only be achieved by treating various causes of vertebral basilar artery insufficiency, such as cerebral atherosclerosis, hypertension, hyperlipidemia, cervical spondylosis, heart disease, diabetes, etc., and giving corresponding treatment to cervical spondylosis, heart disease, vascular malformations, etc. Surgery can include vascular intervention, vertebral artery reconstruction or angioplasty to improve blood flow.

4. General treatment and functional exercise

Cerebral arteriosclerosis, hypertension, cervical spondylosis, etc. are important causes of vertebral basilar artery insufficiency, but so far, there is no specific treatment for these diseases. Early diagnosis, early treatment, effectively improving the blood supply to the brain, promoting the establishment of cerebral collateral circulation, correcting risk factors such as blood lipids and blood sugar, alleviating symptoms, inhibiting the progression of the disease, and preventing complications are current proactive treatment measures.