VERTEBROBASILAR INSUFFICIENCY (VBI)
What is vertebrobasilar insufficiency?
Vertebrobasilar insufficiency (VBI) refers to a condition in which blood flow to the vertebral and basilar arteries is restricted, thereby providing transient insufficient blood flow to the posterior portions of the brain. It is sometimes known as beauty salon or Golden Gate Bridge syndrome, due to the effect of tilting the head back, causing vertigo or drop attacks.
What are the signs and symptoms?
Vertigo, the loss of full control of bodily movements, dizziness, temporary loss of consciousness, ‘drop’ attacks, visual disturbances and motor and sensory changes.
Who gets vertebrobasilar insufficiency?
Risk factors for the development of VBI include:
- high blood pressure (hypertension),
- being over the age of 50,
- family history of the disease,
- elevated lipids, or fats, in the blood (known as hyperlipidemia).
People who have atherosclerosis or peripheral artery disease also have an increased risk for developing VBI.
How vertebrobasilar insufficiency diagnosed?
Your doctor will perform a physical exam and run a series of tests if you have symptoms of VBI.
Your doctor will ask you about your current health conditions and may order the tests such as CT or MRI scans, magnetic resonance angiography (MRA), blood tests to evaluate clotting ability, an echocardiogram, an X-ray of your arteries, which is called an angiogram.
In rare cases, your doctor may also order a spinal tap, or lumbar puncture.
How vertebrobasilar insufficiency treated?
• Medication and lifestyle changes
Patients should quit smoking immediately, attempt to lower cholesterol levels through diet, and exercise regularly. Physicians may also prescribe medication to control high blood pressure, lower blood cholesterol levels and reduce blood coagulation.
• Open Surgical Repair
Three basic surgical procedures can be used to restore flow to the brain through the vertebral and basilar arteries. Bypass grafting, direct arterial or endarterectomy.
• Endovascular repair
A newer technique called endovascular repair is used to treat vertebrobasilar insufficiency by expanding the artery wall.
Can massage help?
Manual therapies such as chiropractic or physiotherapy treatments can create a change in blood flow, but little research has been done to show its effectiveness.
Manual therapists such as massage, physio or chiropractors need to be made aware of the condition in order to take precautions in positioning and treating the client to avoid any ‘drop attack’. If there has been a diagnosis of blood clots massage is contraindicated.
Are there any complications?
The outlook for VBI depends on your current symptoms, health conditions, and age. Younger patients who experience mild symptoms and control them through lifestyle changes and medication tend to have good outcomes. Advanced age, frailty, and strokes can negatively affect your outlook.
How can I avoid getting vertebrobasilar insufficiency?
Sometimes VBI can’t necessarily be prevented. This can be the case for those who are aging or those who’ve had a stroke. However, there are steps that reduce the development of atherosclerosis and VBI. These include:
- quitting smoking,
- controlling blood pressure,
- controlling blood sugar,
- eating a healthy diet that’s rich in fruits, vegetables and whole foods,
- and being physically active.