Narrowing of blood vessels in the cervical spine. Vertebral artery syndrome: symptoms and treatments

A set of the most common symptomatic manifestations: headache, dizziness, the occurrence of tinnitus, the appearance of flickering before the eyes - this is something other than the primary characteristics of such a manifesting pathological process as the syndrome vertebral artery. When diagnosing the disease, vertebral artery syndrome with cervical osteochondrosis Symptoms can manifest themselves both individually and collectively. It is important to have an idea of ​​the nature of the disease, to know the symptoms and treatment, and the causes that can affect its formation.

Etymology of the damaging factor

Vertebral artery syndrome with cervical osteochondrosis has been studied for more than a decade. Numerous studies have been able to identify not only symptomatic signs, causes and methods of combating pathology, but also determine its main characteristics. Cervical osteochondrosis and vertebral artery syndrome is a process that occurs as a result of serious changes in the area cervical region spine. The development of the disease is rapid, the patient experiences numerous symptomatic manifestations As a result of identifying the process of pinching, general well-being deteriorates significantly.

With cervical osteochondrosis, the artery is most often affected. All possible signs manifest themselves when the lumen of the artery narrows with the simultaneous impact of the spinal nerve plexus on it. Due to numerous vessels, the brain is supplied with the necessary amount of blood. If this blood flow is damaged or its functionality is impaired, a syndrome occurs. Despite the fact that it is an independent disease, its occurrence may indicate that the human circulatory system is subject to significant negative changes.

Depending on the nature of the manifestation of the disease, several subtypes are distinguished:

• ischemic;
• dystonic;
• irritative.

Vertebral artery syndrome in cervical osteochondrosis is characterized by changes in certain parts of the brain tissue, the disorders undergo restoration, and in the absence of timely medical care, the occurrence of ischemic stroke. During education bone growths on the edges of the cervical vertebrae make it possible to develop a disease such as spondyloarthrosis of the cervical spine.

It is important to carefully study the symptoms of vertebrogenic cervicalgia in order to formulate subsequent treatment as accurately as possible. This is what will allow you to avoid possible consequences and stop the progression of the disease initial stages its manifestation.

Symptoms of the disease

Often among patients with a similar pathology there are those who have anatomical change structure of the cervical vertebrae or the entire circulatory system. In this case, the development of the disease, vertebrogenic pathology, is influenced by spasms and asymmetry of blood vessels. TO additional factors The genetic predisposition of the body to such anomalies should be attributed.

All signs of the disease dorsopathy of the cervical spine can be divided from characteristic features stage of pathology development. The initial stage is characterized by the occurrence of a headache syndrome (cephalalgia), which can be caused by prolonged exposure of the head to an uncomfortable position, by cooling, or by trauma to the cervical spine.

Pain syndrome (paravertebral signs) have the ability to spread from the cervical region to the temporal region, while the nature of its manifestation may change. At this stage, in parallel with the syndrome, the appearance of pain at the moment of palpating the vertebrae, their character can change from pulsating to tightening and extended. The duration of the manifestation can vary from several minutes to several hours, and it is not excluded that it may be accompanied by other symptomatic signs. Additional symptoms include:

• dizziness - appears after a long rest, may be accompanied by a decrease in visual and auditory activity;
• tinnitus - only one organ of hearing may be affected, this indicates that it is this particular cervical side or vertebral artery that is affected:

During the period of remission, a weak manifestation of noise is observed, immediately before the onset of an attack its strength increases.

• numbness - refers to certain parts of the face or to one of the upper limbs;
• fainting - observed as a result of hyperextension of the head over a long period of time.

Immediately before fainting, the patient may experience dizziness and unsteadiness, facial numbness, impaired speech activity, and possible transient blindness.

• nausea - indicates the onset of pathology;
• depressive state - appears as a result of prolonged headaches or other symptomatic signs listed above.

All existing symptoms manifest themselves after the vertebrae are displaced relative to each other. Often vertebrogenic syndromes can be jumps blood pressure, heart rhythm disturbances, the genesis of the disease mastalgia, the formation of a pain sign in upper limb or education pain syndrome In eyes.

Influencing factors

The reasons influencing the formation of such a disease as tonic cervical syndrome are divided into several options:

1. Vertebrogenic pain syndrome. This bass syndrome is associated with a disorder functional features spine. In patients in childhood Vertebral artery syndrome manifests itself in the form of abnormal developmental disorders of the spine or as a result of injury to the cervical spine. In older age, vertebral arthrosis of the cervical spine occurs after injury varying degrees severity, as a result of muscle contractions and when diagnosing ankylosing spondylitis or other similar pathological disorders.
2. Non-vertebral factors. These include pathologies with impaired patency, for example, arteritis, thrombosis or atherosclerotic lesions, various manifestations reflex syndromes in cervical osteochondrosis. This should also include deformation of blood vessels, their bending and the appearance of scars. In childhood, a factor in the occurrence of vertebrogenic dorsopathy pathology can be an injury received during birth.

Regardless of the cause of its occurrence, vertebral arthrosis of the cervical spine requires high-quality and timely diagnosis and the formation of the most appropriate therapeutic techniques, especially if the patient is diagnosed with vertebral artery syndrome against the background of cervical osteochondrosis.

Relatively often, a patient may experience vertebrogenic thoracalgia, which is the occurrence of painful sensations as a result of the development of an inflammatory process or irritation of the nerve endings of the paravertebral region when the functionality of the spine is impaired and vertebrobasilar insufficiency occurs against the background of cervical osteochondrosis.

The method for identifying vertebrogenic disease involves a number of measures. The main ones include Dopplerography of extratranial sections of vessels, magnetic resonance tomography spine and radiography.

Basic therapeutic measures

One of the most common questions is how to treat pressure in cervical osteochondrosis if vertebrogenic thoracalgia is diagnosed?

After consulting with medical specialist and mandatory medical examination is carried out complex treatment necessary to achieve positive results in the treatment of intervertebral disorders at the cervical level. The key components of therapy are:

• taking medications;
• doing exercises physical therapy;
• changing the patient's lifestyle;
• course of physiotherapeutic measures;
• surgical intervention(with a complex course of pathology or at an advanced stage of the disease).

To the most common medicines include Vinpocetine (to improve cerebral circulation), Betagistone (to eliminate dizziness), Diclofenac (for obvious pronounced manifestation chondrosis). It is important to include medications whose action is aimed at restoring metabolic processes in the body and, if necessary, antidepressants.

Physical exercise is essential to maintain muscle elasticity and tension, thereby improving blood circulation. It is important to remember that the exercises are systematic and regular, and the exercises themselves should not cause discomfort or pain. At the same time, good physio therapeutic procedures. The most effective are acupuncture and manual therapy. All procedures are selected individually.

In cases where the disease is complicated, surgical intervention is required. In this case, surgery is necessary when tumors are detected in the cervical region and when a hernia is detected. Since the disease is considered quite insidious, it is important to detect its presence in the patient’s body in a timely manner and at the initial stages of development.

Against the background of cervical osteochondrosis, treatment as an initial method of eliminating symptoms is the treatment of vertebral artery syndrome in cervical osteochondrosis, a course of massages and physical therapy exercises are prescribed for the treatment of cervical osteochondrosis with vertebrobasilar insufficiency.

Particularly important is drug treatment, the use of injections for vertebrogenic pathology from the group of anti-inflammatory drugs and taking medications, the action of which is aimed at enhancing the process of cell regeneration and improving the metabolism of cervical-brachial syndrome and treatment for the diagnosis of VBN syndrome against the background of cervical osteochondrosis, compression syndromes.

Deserves special attention preventive actions vertebral artery syndrome in cervical osteochondrosis and symptoms of the disease. Moderate physical activity on the body is important if cervical osteochondrosis and blood pressure are related, performing gymnastics and optimal rest.

As a supplement for blood pressure and cervical osteochondrosis, you can consider the option of a course of massages and rest in sanatoriums with a neurological bias, specializing in the treatment of the diagnosis of cervical osteochondrosis and restoration of blood pressure.

This disease, despite the reduced prevalence of its name, is considered common. Many patients do not pay due attention to the signals the body gives. It is especially important to monitor the state of motor activity of the spine so that problems with motor activity do not arise in the future. Timely request for medical care plays an important role in the subsequent course of the disease.

ALS syndrome is lateral amyotrophic sclerosis. This disease relates to serious illnesses With unclear etiology and is characterized by impairment of lower and upper motor neurons. In most cases, a person does not survive with this pathology.

Experts focus on vertebral artery syndrome Special attention. In addition to subjective phenomena (pain, poor eyesight, dizziness), vestibular syndrome negatively affects the nervous system, disrupting some especially important functions. This, in turn, can cause life-threatening conditions such as ALS.

Reasons for the development of pathology

The main cause of the disease is disruption of proper blood circulation in the arteries of the spine. Under normal circumstances, the arteries pass through the canals of the cervical vertebrae and supply not only the spine and neck with the necessary amount of blood, but also, passing through the foramen magnum, supply the brain with it. In the event of any violation of the spinal canals, pathology occurs. Vertebral artery syndrome with cervical osteochondrosis appears if:

• in humans, dystrophic and degenerative changes tissues of the cervical vertebrae;
• there are various anomalies of the vertebrae of the neck;
• vascular compression occurs in the neck, causing tumor growths and scars;
• there is arterial hypoplasia of the vertebrae of the neck;
• in a patient with osteochondrosis with the development of integrity disorders muscle tissue abnormalities occur in the nerve endings and muscles passing next to the cervical vertebrae;
• dystrophic disorders of the spine appear;
• vessels depart from the subclavian arteries;
• There is an intervertebral hernia and osteophytes.

As a rule, pathology of the vertebral artery is provoked by sudden movements of the head, causing compression of the arteries of the spine and disruption of blood circulation in the head.

Symptoms of the disease

The main symptoms of the pathology include:

• throbbing pain in the temporal part of the head;
• disturbances of consciousness;
• gagging;
• loss of clarity of vision;
• dryness and pain in the eyes;
• hearing loss;
• high blood pressure;
• general weakness of the body.

When blood circulation in the brain deteriorates, a person experiences dizziness and double vision, nausea, speech impairment and headaches.

Diagnosis of the disease

If the disorder of the vertebral artery was caused by cervical osteochondrosis, then diagnostic measures aimed at studying the characteristics of pathology. To identify this syndrome, you need to contact qualified specialist- neurologist. The doctor will listen to the patient’s complaints, study all the necessary data collected during the neurological examination, and make a diagnosis. accurate diagnosis. Patients often experience muscle strain in the occipital region, as well as painful sensations when palpating the cervical vertebrae and difficulty moving the head.

Diagnostic measures for detecting vertebral artery syndrome include various studies, the main ones being:

• X-ray of the cervical vertebrae;
• Analysis of urine;
• general blood analysis;
• Dopplerography of blood circulation.

If required, the doctor can perform a magnetic resonance imaging scan of the brain. Most often, this procedure is prescribed if the patient is suspected of having cerebral ischemia. Only MRI helps to correctly determine the location where arterial compression occurred. Moreover, examination of the cervical vertebrae using MRI is carried out to clarify the condition intervertebral discs and identifying pathological disorders of the spinal column.

After a thorough diagnosis, the patient is prescribed disorders of the spinal arteries and given some general recommendations.

Treatment of pathology

If the cause of the disease is cervical osteochondrosis, then, first of all, treatment of vertebral artery syndrome is based on eliminating the unpleasant symptoms of osteochondrosis. To achieve maximum positive results, the patient is prescribed a comprehensive treatment, which includes:

• drug therapy;
• surgery;
• physiotherapy;
• physiotherapy.

In addition, vertebral artery syndrome against the background of cervical osteochondrosis can be treated at home with the help of various medicinal plants and herbs.

Drug treatment

All drugs for the treatment of spinal arteries are selected based on the symptoms of the syndrome and individual characteristics the patient's body. Basically, the doctor may prescribe the following medications:

Anti-inflammatory drugs, promoting the removal inflammatory processes and pain. The most effective are Nimesulide and Ibuprom. The dosage and duration of therapy is determined by the attending physician.

Agents that normalize venous blood flow. Most often prescribed for vertebral artery disease Diosmin or Troxerutin. If treatment takes place in a hospital, then use L-lysine, which is administered using a dropper.

Drugs for restoring arterial patency in the spine. The main drugs are Trental And Agapurin.

Drugs that have the ability to reduce cerebral hypoxia. In this case, they can be prescribed Mexidol And Actovegin.

Drugs that normalize cerebral circulation. More effective are Thiocetam And Piracetam.

Drugs with neuroprotective effects. These include Gliatilin And Somazin.

Medicines for dizziness. If a patient with osteochondrosis and spinal artery syndrome often gets dizzy, then he is prescribed Betaserk or Betagistine.

In addition to these medications, vitamins A, B and C are used to treat pathology. A course of taking chondoprotectors may also be prescribed.

Physiotherapeutic treatment

During the period when the disease becomes acute phase, the doctor prescribes physical therapy aimed at eliminating pain impulses that arise in the nerve fibers of the neck.
Physiotherapeutic treatment consists of the following procedures:

1. Diadynamic procedure. The essence of the therapy consists of exposing the patient to electric current. The duration of the procedure is five minutes.
2. Ultrasound therapy. More often, ultrasound treatment uses a pulsed mode of exposure.
3. Photophoresis. The procedure is performed using Anestezin and Analgin.
4. Electrophoresis. Therapy is combined with the use of ganglion blockers.

The latter can be carried out using Papaverine, Euphyllin, Novocaine or Iodine.

Thanks to physiotherapeutic procedures, it is possible to influence the deepest layers of the cervical and spinal tissues.

In the initial stages, vertebrobasilar disease is treated with neck galvanization and acupuncture. In addition, a specialist can prescribe manual therapeutic procedures and special nutritional therapy.

Surgical treatment for violation of the vertebral artery caused by osteochondrosis of the neck is prescribed if conservative methods The therapy did not bring a positive result even in cases where the lumen of the patient’s spinal artery is more than two millimeters in size.

Today at modern clinics Vertebrological neurosurgery operations are performed using endoscopic technologies. The size of the incision does not exceed two centimeters, and there is no risk of compromising the integrity of vital organs. The operation technology is carried out in two stages. First, the doctor excises the narrowing site and performs vascular plastic surgery. The balloon is then inserted with the stent. If the patient has a hernia or neoplasm, then surgery is used to eliminate the compressive effect on the arteries. Surgical treatment of pathology gives ninety percent positive result. The patient completely gets rid of signs of insufficiency of cerebral blood supply.

Physiotherapy

One of the excellent ways to get rid of the problem associated with the vertebral artery and cervical osteochondrosis is therapeutic exercise. All exercises must be performed carefully, without sudden manipulation.

Breathing during exercise must be done through the nose. All exercises are performed at least ten times.

The most effective exercises are:

If the syndrome has subacute period, then the patient can benefit from massage, which is performed to relax muscle tension in the neck, which helps reduce compression of the spinal arteries. If massage is done incorrectly, the patient may develop thromboembolism. pulmonary arteries, compression of neck vessels, and sometimes stroke.

Traditional healing

Home treatment based on intake healing decoctions and tinctures, is an addition to the main therapeutic healing. This technique helps to increase efficiency when taking medications.

It is worth noting that folk remedies cannot become a substitute for medication or physiotherapeutic treatment.

There are many remedies available to help relieve the symptoms of spinal artery syndrome, but traditional healers It is recommended to use the following recipes:

Horse chestnut. An infusion is made from the plant. To do this, chestnut seeds (450 g) are poured boiled water and put it in a dark place to brew for six days. After this time, the infusion is filtered and taken in the morning, at lunch and in the evening, 2 teaspoons before meals. The product helps greatly with increased blood clotting.

Garlic. Take a few large cloves of garlic and chop. The resulting mixture is placed in a jar and stored in a warm place for two days. Afterwards, the composition is filtered and mixed with lemon juice and liquid honey in equal quantities. The drug is taken in the evening, a few teaspoons at a time. For vertebral artery syndrome, the drug helps thin the blood.

Chamomile. Infusion from medicinal chamomile relaxes muscles well and relieves pain. To prepare it, you need to take dry flowers of the plant (250 g), mix them with natural honey (100 g), add boiled water (1 liter) and put on medium heat. After fifteen minutes, remove the mixture and store in a cool, dark place for two weeks. Afterwards, strain the broth and drink 50 ml several times a day.

Hawthorn. To dilate blood vessels ethnoscience advises taking a decoction based on Hawthorn. Berries (30 g) poured hot water(300 ml) and place on medium heat. After ten minutes, the broth is removed and kept for another half hour in a cool place. You should take several small spoons in the morning and evening.

To reduce blood clotting and prevent blood clots, the patient needs to eat more fruits and berries, which contain a lot of vitamins A and C. These can be citrus fruits, Lingonberries, Strawberries, apples and Rose Hips.

1. If the pathology is caused by cervical osteochondrosis, then the patient is recommended to use a Shants collar, which is worn daily for several hours. Thanks to this device, pain and tension in the neck are reduced and muscle stretching is normalized.
2. You should sleep on an orthopedic pillow and a semi-rigid mattress.
3. To get rid of pain, you need to wear a woolen scarf or rub your neck with snake and bee venoms.
4. Nutrition for illness should consist only of natural products. Great emphasis is placed on the consumption of nuts, juices from vegetables and fruits, fresh berries and beans.

Disease prevention

To prevent vertebral artery syndrome, you should adhere to the following recommendations:

• Do various exercises that help strengthen muscles. These include various manipulations with the head, especially nodding, turning and bending.
• When acute pain in the neck area, it is necessary to place a roller with hot sand under it.

The disease is characterized by a lack of blood in the neck and brain, so the disease is considered a life-threatening condition. When the first symptoms appear, you should immediately visit the appropriate doctor and follow all his recommendations when treating the pathology. If the disease is advanced and progresses rapidly, the patient may be admitted to the hospital for treatment through surgery.

In the list of health disorders associated with cervical osteochondrosis, special place occupies the so-calledvertebrobasilarsyndrome. Special because along withotherscerebrovascular disorders this pathology not only reduces the patient's quality of life, but, if not treated promptly, can pose a serious threat to the patient's health and well-being.

What is vertebrobasilar syndrome?

WITHvertebral artery syndrome with cervical osteochondrosis is a complex of disorders that arise due to hemodynamic disturbances in the vertebral artery basin. This condition is one of the complications of cervical osteochondrosis, capable, due to the specific anatomical features of the vertebral artery, of leading to disorderfunctioningalmost all organs and systems.

Crystal attention to this pathology is due to that, in addition to subjective discomfort(pain, dizziness, vision problems), vertebrogenic the syndrome can negatively affect the vital functions of a number of structures of the central nervous system, which causes health and life-threatening conditions.

Causes

The reasons for the development of this pathology lie in the anatomical features of the cervical department of the spine and in particular the most arteries. This paired vessel is a branch approaching the sixth cervical vertebra, vertebral arteryenters the canal formed by the processes of the cervical vertebrae (from the first point about the sixth) . From this canal the vertebral artery enters scull .

Lying in the bone canal, the vertebral artery susceptible and deformations with the slightest instability of the cervical vertebrae , as well as with a decrease in the height of the intervertebral discs.

Development mechanismsvertebrogenic syndrome:

1. Due to Deformation of the artery reduces the volume of blood flow through it, which leads to a disruption of the blood supply to the basal structures of the brain.
2. Another development mechanism pathological symptoms associated with cervical osteochondrosis is irritation or even infringement of the sympathetic nerve bundle that runs along with the vertebral artery. Injury to nerve fibers leads to the rapid development of neurological symptoms.

This is how a pathological symptom complex is formed, better known asvertebral artery syndrome due to cervical osteochondrosis.

Risk factors

There are a number of conditions that make it more likely thatvertebral artery syndrome occurs with cervical osteochondrosis (causes of the diseaselie in the pathology of the spine), This:

1. WITH am osteochondrosis.
2. AND excess body weight, characteristic of obesity.
3. Systemic diseases accompanied by metabolic disorders (diabetes mellitus, atherosclerosis).
4. H excessive emotional stress and physical stress.
5. WITH systematic toxic effects (alcohol, nicotine).
6. Genetically determinedpredisposition to vascular disorders.

Clinical manifestations

Symptoms given vascular pathology very recognizable:

Expressed p attack-like headaches, characterized by a pulsating character and spreading from back surface neck to the back of the head, and from there towards the temples and frontal region.More often headaches vertebrogenic syndrome has unilateral localization.

• B painful sensations, localizeddirectly tosurface of the scalp.
• N vestibular disorders th apparatus: feeling instability as while walking, so and at rest, swaying, episodes of dizziness, hearing loss, audibility of extraneous sounds in the form of ringing or tinnitus."Swimming away the floor from under your feet" when turning your head sharply.
• Subjective decrease in visual acuity due to sparks, flies, fog or veil flashing before the eyes, feeling of sand in the eyes.
• N muscle tension and soreness neck (especially during palpation).
• Episodes of numbness in any area of ​​the face.
• Violations in the area cardiovascular with pheres in the form of episodes of tachycardia, pain in the chest, a feeling of lack of air during inspiration.
• Psychological manifestations in the form of attacks of aggression, panic attacks, depressive states or a tendency toward apathy.

In addition to high blood pressure, which often accompanies , main symptoms this vascular disorderV severe cases may be accompanied by the following symptoms:

• T nausea that occurs at the height of the attack and ends with vomiting.
• P cracking and crunching when making movements in the cervical region - tilting and turning the head.
• U intensification of pathological phenomena with sides vision: double vision, narrowing of the field of vision, blurred vision.
• P progression of hearing loss and increased pathological noise.
• R swallowing disorder.
• Deterioration of sensitivity of the skin of the lips, mucous membrane of the tongue and pharynx; numbness and paresthesia in these areas.
• P loss of consciousness. Often this condition is preceded by a backward position of the head (as, for example, when looking up). Approximation loss of consciousness can be recognized by increased nausea and dizziness, speech impairment, and sudden loss of vision in one of the eyes.

These signs, combined with pain and other signs exacerbation of cervical pathology practically unmistakably point to.

Diagnostics

Variety of subjective signs vertebrogenicsyndrome and different perceptions of complaints by different patients are significantly makes diagnosis difficult vertebrobasilar syndrome . In this regard, a list of mandatory examinations was developed to identify objective signs characteristic of this pathology.

• D complex scanning or Doppler ultrasound of arteries to identifyextravasaldeformations of the vertebral artery.
• X-ray of Shane s vertebrae using functional tests and image fixation during flexion and extension of the cervical spine.

• M RT (m magnetic resonance imaging) revealing presence, degree andlocalization of blood vessel deformations.

Cervical osteochondrosis syndrome is diagnosed when the patient has three main clinical criteria:

1. N the presence of a set and combination of symptoms characteristic of a given pathology.
2. IN identified using methodsmagnetic resonance imaging and x-ray And typical changes.
3. Characteristic abnormalities detected during scanning, as well as during Dopplerography of the vertebral arteries using stress tests, when bending and straightening the head.

This list of diagnostic criteria was established to avoid overdiagnosisvertebrogenic syndrome.

The importance of differential diagnosis

Sharp attacks of headaches combined with dizziness and nausea against the background of rising blood pressure, as well as the likelihood of loss of consciousness, may indicate both stroke in vertebro-basilar basin, transient ischemic attack or infectious-toxic lesion nervous tissue with neuroinfections, and to identify vertebral artery syndrome in cervical osteochondrosis. Symptoms arise suddenly, which makes it difficult to collect anamnesis. Both conditions are classified as emergencies and are indications forhospitalization and detailed examination.

Differential diagnosis is necessary for correct selection of treatment for each of the listed diseases.

Drug therapy

In case of vascular pathology, to which includes, treatmentmust be comprehensiveand address not only the etiology, but also focus on the correction of disorders resulting from circulatory disorders.

1. The first step drug treatment is selection non-steroidal anti-inflammatory drugs to eliminate neurogenic inflammation. Etc priority is given drugs from the NSAID group electoral type,blocking only the enzymecyclooxygenasesecond type; This approach combines effectiveness in combating the disease withsafety for the patient. Typical representatives of this group of drugs are products based on nimesulide, meloxicam or celecoxib.
2. A number of disorders that cause symptoms in vertebrogenic syndrome, develops under the influence of pathologicalhypertonicity muscles of the neck and This is one of the signs that we have before us- vertebral artery syndrome with cervical osteochondrosis. Reviewspatients testify that the inclusion of muscle relaxants in the treatment regimen contributes to a more rapid normalization of well-being and general condition. From a group of suchdrugs good effect give "M" Idocalm", "S irdalud", "B aclofen" . By eliminating muscle spasm, muscle relaxants reduce the intensity of pain, thereby reducing the need for non-steroidal anti-inflammatory drugs.Important point! During the period of application of these medicines You should refrain from activities that require increased attention and quick reactions.In addition, such work is incompatible with vestibular disorders, which manifest.
3. Treatment of conditions caused by hemodynamic failure vertebrobasilar area, unthinkable without the use of funds, normalizing microcirculation , bioactive substances and other drugs whose action is aimed at combating tissue hypoxia.

Physical methods

As an independent healing technique, physiotherapy insufficiently effective; requires integrated approach to treatment.However, as an auxiliary physiotherapy gives quite good results.

Massage for vertebrogenic syndrome is often contraindicated even during remission, since it can cause displacement of the vertebrae and pinching of the neurovascular bundle.

The preferred technique for this pathology is reflexology, which can relieve muscle spasms without harming the patient or aggravating his condition.

The orthopedic regimen is of no small importance (immobilization of the cervical spine using I wear Shants collar). This one is especially important moment in cases where deterioration patient's conditionassociated with changes in position or movements of the head.

Outside of an aggravation, it is necessary to take a set of measures to strengthenmuscular frame of the neck. Due to the specific nature of the pathology, the decision on the advisability of exposure through massage or exercise therapy must be taken by a specialist. Exercises alsomust be fulfilledunder the supervision of a specialist.

Traditional methods

Among the recipes containing folk experience in the treatment of certain disorders, there are also means that help cope with with some manifestationsvertebrogenic syndrome.

1. Using garlic to reduce blood viscosity. For getting medicinal composition three large heads of garlic must be chopped and kept in the dark those three days. Then the mass must be filtered and added to it equal quantities honey and lemon juice. P and t Before going to bed, take a tablespoon.
2. Takingcomposition preparedfrom 40 grams of corn silk, 20 grams of lemon balm, lemon juice andglass of boiling water. After an hour of infusion, takehalf a glass three times a day 30 minutes before meals.

It should be remembered: in such a serious situation as causes diseases and multiple disordersare not eliminated herbal infusions or others folk remedies. A complete scheme therapy can only be prescribed by the attending physician after a detailed examination of the patient. Folk remedies are used as auxiliary; their use is permissible subject to the following conditions:

• No allergic reactions to ingredients.
• ABOUT no contraindications and approval of the attending physician.

Indications for surgical treatment

Decision on surgical intervention accepted in case of development due tovertebrogenic syndrome the following pathological conditions:

• AND ischemic attacks, strokes.
• And intellectual-mnestic, cognitive disorders.
• WITH rapid progression of disorders vision, hearing and balance.

In addition, cases wherecombined with pronounced arterial hypertension, anatomical abnormalities of the vertebral artery or atherosclerosis, as well as the ineffectiveness of therapeutic measures.

Complications

The most serious complication of vertebrobasilar syndrome is a stroke. Its consequences can be:

• AND loss of hearing.
• P complete loss of vision.
• WITH Cardiovascular failure.
• Insufficiency of the respiratory system.

Vertebral artery syndrome (VAS) is a complex lesion in which the cerebral blood supply is affected. This is due to a narrowing of the lumen of one of the arteries of the spine. SPA is the cause of 70% of ischemic attacks, as well as 30% of brain disorders associated with lack of blood circulation. The disease can be fatal.

SPA is associated with a narrowing of the lumen of the right or left vertebral artery. These blood pathways run from the subclavian artery to the brain, connecting into a single highway near the entrance to the skull.

The arteries pass through the vertebral processes of the cervical spine. They are closely intertwined with nerve endings. Due to the location of the arteries between the vertebrae vascular pathways can easily be pinched, and along with them the nerve pathways.

The blood supply lines in question provide nutrition to the spinal cord, as well as the cerebellum and medulla oblongata. In general, the vertebral arteries provide 30% of the blood supply to the brain; they participate in the nutrition of not only these areas, but also in partially supplying other areas of the brain. If blood circulation in the arteries in question is impaired, the patient begins to suffer from a variety of unpleasant symptoms that can significantly worsen his quality of life.

Pathogenesis of SPA

SPA develops in people of any age, although due to senile changes it is more often diagnosed in people of the pension category. There are many reasons that trigger the development of vertebral artery syndrome. There is SPA of extravasal, occlusive and anatomical etiology.

Extravasal factors include disorders of the structure of bone and soft fabric resulting from various pathologies or congenital features. This is the displacement of the vertebrae, the occurrence of tumors, the development of compensatory bone tissue, excessive muscle tension. All of these factors lead to compression of the arteries, which disrupts the blood supply. The listed problems are observed in the following diseases and syndromes:

• osteochondrosis;
• Platybasia;
• spondyloarthrosis;
• disturbances in the structure of the cervical vertebrae;
• intervertebral hernia;
• spasms of the longus, inferior oblique and other muscles due to excessive tension and incorrect position bodies.

Extravasal disorders rarely lead to serious consequences. Because of them, the nerve endings and arteries are not fully compressed. Although the lumen of the vessel narrows, it remains sufficient for the brain and spinal cord to continue to receive nutrition. Due to the compensatory functions of the body, for example, increasing pressure in the vertebral arteries in order to improve blood circulation, the patient can remain relatively healthy and not even notice the presence of SPA.

The most serious cases of the syndrome have been reported in occlusive disorders vascular system. These are lesions in which the blood passages are blocked, causing the blood supply to entire parts of the body to stop. Given the importance of the vertebral arteries, blockage can be fatal. Occlusive lesions occur against the background of the following diseases:

1. embolism;
2. thrombosis;
3. atherosclerosis;
4. systemic vasculitis;
5. hypoplasia of the vascular wall.

Often a blood clot forms in a blood vessel, which leads to impaired blood circulation.

The third group of causes of SPA includes anatomical features the artery itself. There are congenital disorders that cause the arteries to become too kinked in certain areas. They lead to the fact that even in the absence of diseases of the cervical spine, the patient suffers from a lack of blood supply.

Symptoms and classification of SPA

Vertebral artery syndrome is divided into two subtypes: dystonic and ischemic. This clinical classification, it is based on the patient's symptom complex. Dystonic type of SPA is initial stage diseases when the symptoms of the pathology are still pronounced. With the ischemic type, serious lesions already appear.

Symptoms of dystonic spa:

• frequent, causeless headaches;
• visual disturbances;
• migraine;
• violations vestibular apparatus(loss of balance, frequent dizziness, loss of consciousness).

Depending on the causes of the syndrome, with the dystonic type of the disease, pain in the cervical spine may also be observed. This symptom associated with tumors, disorders of the structure of bone tissue in osteochondrosis.

During the ischemic stage of RAS, morphological, largely irreversible changes in tissue begin. The severity of symptoms increases significantly. The following signs of the disease appear:

1. nausea and vomiting;
2. disorders of the nervous system (lethargy, numbness of the limbs and neck, decreased sensitivity):
3. dysarthria (speech disorders);
4. constant loss of consciousness.

As a result of SPA, ischemic attacks can begin, which often lead to a cerebral stroke.

Depending on the degree of development of the disease, the patient may also experience the following disorders and ailments:

• Basilar migraine. Characterized by nausea and vomiting, pain in occipital region, in some cases speech disorders occur. It is ophthalmic in nature, so it may cause fog in the eyes or temporary blurred vision.
• Vestibular-cochlear syndrome. Patients with this type of disorder experience hearing impairment and have difficulty distinguishing whispers. They also feel unsteady and suffer from dizziness.
• Vestibulo-attack disorder. With sudden movements and turns of the head, the patient experiences dizziness. At the same time, darkening of the eyes and a feeling of nausea develop.
• Autonomic disorders. Abrupt appearance heat and its change to chills, tachycardia, lack of oxygen, insomnia. Sometimes excessive sweating occurs.

Diagnosis of the disease

SPA requires a thorough, multifaceted diagnosis. Since the syndrome can be caused by reasons of different nature, it is necessary to carry out a long differential diagnosis. Instrumental examinations and laboratory tests are required.

Diagnosis of the disease begins with a visit to the doctor. A specialist may refer a patient for examination with a preliminary diagnosis of SPA if the following symptoms are detected:

1. frequent dizziness and loss of consciousness;
2. causeless headaches;
3. speech disorders;
4. numbness of the limbs.

Additional diagnostic signs are pain and spasms in the cervical spine, and blood pressure disorders. However, these symptoms do not relate directly to SPA, but to the disease that led to the development of the syndrome.

After collecting the primary anamnesis, instrumental diagnostics. The patient may additionally be referred to an ophthalmologist, otolaryngologist, or vestibulologist.

A neurologist is appointed as the attending physician. It defines the basic methods of diagnosing and treating the patient.

TO instrumental studies SPA includes:

• Radiography. It is a preliminary examination method. Allows you to establish a diagnosis, but does not clarify it. If SPA is confirmed during radiography, specialists prescribe to the patient additional examinations presented below.
• MRI of the spine and brain. Required for condition assessment spinal cord, as well as for diagnosing morphological disorders of the brain.
• CT scan of the spine. Allows you to determine the source of the disease if the cause lies in disorders of the structure of the spine or soft tissues.
• Duplex scanning and ultrasound of cerebral vessels. These techniques allow you to study the characteristics of blood flow through the introduction of contrast agents. Specialists identify areas of arterial compression and blockage.

If vision or hearing impairment is observed, procedures such as ophthalmoscopy and audiometry may be prescribed.

Therapy methods

Spa therapy greatly depends on the cause that caused the development of the disease. The treatment complex usually includes the following methods:

1. taking medications that improve blood flow and dilate arteries;
2. myofascial massage;
3. manual therapy;
4. wearing a Shants collar or other neck braces;
5. symptomatic therapy to relieve headaches, muscle spasms, nausea and vomiting;

The above applies to conservative treatment methods. If there are complications and therapy is ineffective, surgical intervention is performed.

Cost of examinations

Preliminary inspection, as well as a number of instrumental examinations can be done at a public clinic or hospital. However, in regional medical centers Often some equipment is missing. Even in major cities diagnostic equipment may be outdated, which not only reduces the effectiveness of diagnostics, but also leads to increased exposure of patients. If a patient wants to receive a more qualified diagnosis with a minimum of harm to health, it is better to go to paid clinics for examinations.

Average cost of examinations:

• MRI of the cervical spine – 5,000 rubles;
• duplex scanning of the circulatory system of the brain – 2750 rubles;
• Ultrasound examination – 2600 rub.;
• CT scan of the spine – 8000 RUR;
• radiography – 3700 rubles;
• audiometry – 1500 rub.

Overall for complex diagnostics If there are no complications, SPA treatment will have to cost from 5 to 15 thousand rubles.

Rapid development latest technologies, the introduction of systematization of all work processes led to the fact that a large number of people complain of pain in the spine. Once diagnosed, your doctor may make a diagnosis of vertebral artery syndrome (VAS). This most difficult pathology to diagnose can be caused by in a sedentary manner life. Quite often, it affects people who spend most of their time at the computer, in the office, or simply doing sedentary work.

The whole difficulty of diagnosing lies in the fact that under the same diagnosis various specialists imply great friend from another disease, such as:

• posterior cervical sympathetic syndrome;
• compression of the vertebral artery;
• dyscirculatory encephalopathy.

In order to understand the reasons for the development of SPA against the background of cervical osteochondrosis, you should know about some of the features of this blood vessel.

There are four segments of the vertebral artery:

• segment I – from the subclavian artery into the bone canal (BC) CII – CVI;
• segment II – CC CII – CVI;
• segment III – from CC CII into the cranial cavity;
• segment IV - in the cranial cavity, connection with the vertebral artery of the other side.

In cases where a person’s spine is affected by osteochondrosis, the lumen in the vertebrae through which the vertebral artery passes narrows, causing pathological bending and compression.

Osteophytes, which always form during osteochondrosis, have a maximum compressive effect on the artery, causing its displacement, and some of the vertebrae are also extremely mobile, causing constant injury to the vertebral artery by the vertebra adjacent below.

The clinical picture is divided into two stages - functional (dystonic) and organic (ischemic).

At the first, dystonic stage, patients note:

• throbbing headache;
• dizziness;
• hearing loss;
• poor orientation;
• visual disturbances.

In conditions where the patient does not want or, for some reason, cannot be treated, ischemic foci appear in the brain, aggravating the patient’s condition.

Note! The organic stage is diagnosed in cases where patients experience persistent cerebrovascular accident (CVA).

Signs of bad cerebral blood flow:

• dizziness;
• poor concentration;
• unsteady gait;
• attacks of lightheadedness and vomiting;
• decreased range of motion;
• slowness of speech.

There are other forms of cerebral ischemia that develop when the vertebral artery is damaged. Similar incidents occur when a person tilts his head or turns quickly. The main sign of organic cerebral ischemia is a sudden fall with preservation or loss of consciousness.

Note! When lying down, patients with this symptom are tormented by noises in the head and a general deterioration of their condition.

Diagnosing vertebral artery syndrome has a number of difficulties due to polymorphism clinical symptoms and the fact that not always, when x-ray examination, are revealed pathological processes.

Therefore, recently, doctors have identified three main diagnostic criteria by which the diagnosis is made:

1. Symptoms. The presence of several of the above-described signs of vertebral artery syndrome.
2. Osteochondrosis. Lesion in the cervical spine.
3. Duplex scanning PA. Identified pathological processes.

Despite the fact that each doctor has his own diagnostic method, there is a protocol listing diagnostic procedures, mandatory for suspected vertebral artery syndrome.

List of procedures:

1. Blood analysis. Biochemistry, ESR, coagulability, lipid profile.
2. Study of the hypercoagulable state of patients over 45 years of age. The presence of lupus anticoagulant and antithrombin III deficiency is established.

Instrumental examination:

1. CT scan. Early cerebral ischemia may not be visible at the first examination.
2. Magnetic resonance imaging. CT is preferable, since it almost never misses ischemia and brain tumors, as well as diseases of the blood vessels.
3. MR angiography – in combination with MRI gives the most accurate indicators.
4. Electrocardiogram. Mandatory examination for all patients with suspected RAS.
5. Echocardiography. Should be prescribed to young patients with basilar artery occlusion.
6. Cerebral angiography. Due to non-invasive imaging, the examination is used less frequently than the above procedures.

Due to the variety of symptoms, treatment measures involve wide range drug effects.

The main point of treatment is anti-edematous and anti-inflammatory measures, and the first thing they do is try to relieve venous dysgemia.

Drugs affecting venous outflow:

• diosmin;
• troxerutin.

Anti-inflammatory drugs:

• nimesulide;
• celecoxib.

Drugs that normalize blood flow in the vertebral artery:

• vincamine;
• instenon.

Drugs that improve brain metabolism:

• citicoline;
• Cerebrolysin.

Drugs that relieve some symptoms:

• sumatriptan;
• vitamin B (standard doses).

If doctors believe that the disease has taken over life threatening patient form - an operation is prescribed, during which neurosurgeons, according to indications, remove uncovertebral osteophytes (growths), or form an anastomosis between the vertebral artery and the external carotid artery.

TO alternative methods treatments include the following types physical impact, How:

• massage;
• manual therapy;
• acupuncture;
• physiotherapy;
• physiotherapy.

Note! In case of vertebral artery syndrome, it is not recommended to make sudden movements of the neck, as this can aggravate the already painful condition person.

The only way out and one of the types are isometric exercises, the meaning of which is that the head and neck remain motionless, and the arms work, and these actions are performed as follows:

Lateral tension - put your hand on your temple and begin to press lightly, while straining your neck, as if offering resistance. The force with which the hand presses on the temple and the resistance force should be equal, that is, the head will remain motionless (perform on both sides).

Do the same by placing your hand on your forehead and then on the back of your head. The duration of each press is 5 seconds.

Note! In the first days of classes, the condition may worsen.

For vertebral artery syndrome, against the background of cervical osteochondrosis, acupressure is performed.

The biological point that should be massaged is located on the border of the first and second phalanx thumb, at the end of the groove that appears when it is bent. Pressure (for 5–10 seconds) is applied first on one side of the finger, then on the other, alternately on both the right and left hand.

Note! Yoga is one of the most effective means in the fight against vertebral artery syndrome. Moreover, Tibetan doctors They believe that treatment should begin not with medication, but with yoga, and many European doctors agree with this technique.

When using vascular drugs, against the background of compression of the vertebral artery, the microcirculation of those areas of the cervical spine that are already well supplied with blood will increase, while the compression is not treated in any way. To avoid this incident, measures should be taken to eliminate the displacement of the cervical vertebrae and eliminate the shortening of the occipital muscles.

Only after the compression has been released can you connect vascular drugs.

Asanas used

Shalabhasana

Lie on your stomach, arms extended along your body (palms up). Inhale, while trying to lift your shoulders and legs off the floor, that is, the fulcrum for the body will be the stomach. Stretch your arms and legs back, head forward. Try to hold in this position for at least a minute. Exhale and return to i. P.