Spinal artery syndrome with cervical osteochondrosisSpinal artery syndrome is a combination of symptoms that develop when the vertebral artery is compressed or the sympathetic plexus located around it. This syndrome is accompanied by a violation of blood supply to the brain, so it requires timely diagnosis and treatment.
Compression( compression of vertebral arteries) is usually recorded under the following conditions:
- anomalies or scoliosis in the cervical spine;
- compression of vessels due to scars or tumor formations;
- hypoplasia of vertebral arteries and atherosclerosis, in which the normal blood supply to the brain tissue is disrupted;
- abnormalities of muscles and nerves that pass near the cervical spine;
- high placement of the dentate process of the 2 cervical vertebra;
- dystrophic lesions of the spine;
- compression of the vertebral artery is also observed with atypical vascular withdrawal from the subclavian artery.
Very often, the syndrome of the vertebral artery develops against the background of cervical osteochondrosis, with intervertebral hernia, as well as in the formation of osteophytes.
As a rule, provoking factors become very sharp slopes or head turns, in which there is compression of the vertebral artery and deterioration of the blood supply to the head. It should be noted that the definition of the cause of vertebral artery syndrome is extremely important, since it helps to decide the doctor how to treat the patient.
Clinical manifestations of
Among the main manifestations are the following:
- pulsating headache, which is located on one side, usually in the region of the temples or parietal region, above the eyebrows and is strengthened during physical exertion or after sleep with the head thrown back;
- nausea, vomiting, impaired consciousness during sudden movements;
- often patients complain of pain in the eyes and their excessive dryness, reduced visual acuity;
- symptoms of vertebral artery syndrome also include hearing impairment, patients complain of ear pain and ripple in the head;
- , there are signs of cardiovascular damage, angina attacks and a sharp increase in blood pressure are possible.
Deterioration of blood circulation in the brain is manifested by severe dizziness, nausea and vomiting, violation of coordination of movements and speech, diplopia( double vision in the eyes) is possible.
In cervical osteochondrosis, compression of the vertebral artery is characterized by the appearance of specific pain sensations that are localized in the parietal or temporal region. They are accompanied by eye, ear, and also pharyngeal manifestations. The pain is burning. Patients complain of constriction or raspiranie in the throat, eyes or ears, which increases with sudden changes in the head, and after a night's sleep in an uncomfortable position.
A characteristic feature of visual and vestibular disorders is that in most cases they appear not in isolation but are recorded and amplified during headache attacks. This is the so-called vertebrogenic syndrome, which is associated with degenerative-dystrophic changes of the spine.
To identify the syndrome of the vertebral artery, the patient should be consulted by a neurologist. The diagnosis is made on the basis of patients' complaints and data that are obtained during a neurologic examination. Often find muscle tension in the nape of the neck, hampered head movement, tenderness when palpation of the transverse processes of the 1st and 2nd cervical vertebra.
Correct diagnosis should include additional( instrumental) studies. As a rule, patients are recommended to undergo roentgenography of the cervical spine, dopplerographic examination of blood flow through vertebral-basilar arteries.
If necessary, the MRT of the brain is prescribed, especially if there is a suspicion of ischemia of its tissues, since it is this examination that makes it possible to clearly determine the localization of the site of compression of the artery. In addition, magnetic resonance imaging of the cervical spine can be performed to assess the condition of the vertebrae and intervertebral discs, as well as for the timely detection of pathologies of the spinal column.
Treatment of vertebral artery syndrome
The main objectives of therapy in this pathology is to restore adequate blood circulation, as well as eliminate the provoking factors that lead to spasm of the vertebral arteries. In most cases, a comprehensive program is used, aimed at rapid relief of pain and other unpleasant symptoms.
With neostromy course of the disease treatment is carried out at home. If there is a suspicion of an acute disruption of the blood circulation of the brain, an immediate hospitalization is carried out. Depending on the etiology and severity of clinical manifestations, treatment includes the following:
- periodic dressing of the orthopedic collar of Shantz, which reduces the burden on the cervical spine and limits movement in this area. It is selected individually for each patient;
- manual therapy, which allows you to restore the anatomical position of the structural units of the spine. In the presence of contraindications, only light massage of the collar zone is done;
- uses acupuncture to reduce pain and eliminate dizziness;
- also uses physiotherapy techniques. As a rule, magnetotherapy, electrophoresis with analgesics, phonophoresis with hydrocortisone;
- after the abatement of the pain syndrome is recommended to perform special exercises to strengthen the muscular corset;
- medication is used to treat pain. To this end, prescribe analgesics, non-steroidal anti-inflammatory drugs, as well as drugs that improve cerebral circulation( eg, Cavinton or Cinnarizine) and normalize blood pressure and heart rate. In vertebral artery syndrome, it is important to control the level of cholesterol and the state of the blood coagulation system. A positive therapeutic effect is provided by antioxidants and drugs that reveal a neurotrophic effect. Sometimes medical medicated blockades are used.
If conservative therapy is ineffective, resort to surgical treatment - endarterectomy, arteriolysis, surgical interventions that restore the patency of compressed arteries( removal of osteophytes, stabilization of excessively mobile vertebrae of the neck).In addition, an operation can be performed that involves the re-implantation of vertebral arteries.
It should be noted that surgical treatment is the most effective and allows for a long decompression of compressed vessels, which in turn leads to an improvement in the patient's condition and to the complete disappearance of pathological symptoms.
Syndrome of vertebral artery in cervical osteochondrosis: causes and treatment ofSyndrome of the vertebral artery in cervical osteochondrosis is one of the most severe manifestations of age-related degenerative changes in the cervical spine. One of the leading symptoms of the disease is severe headache or vertebrogenic syndrome, which appears when the vertebral artery is compressed or the plexus surrounding it. The disease progresses rapidly and can begin even at a young age. Contents:
- Surgical treatment of
Causes of the appearance of the syndrome
The main cause of the appearance of the disease is the violation of blood circulation through the vertebral arteries. Normally, they pass in the cervical vertebrae( in the channels of the transverse processes) and not only the blood supply to the neck. They enter the skull through the occipital foramen and nourish the brain. With any lesions of the vertebral canals, the disease begins to progress steadily. What conditions are characterized by these disorders:
- when degenerative-dystrophic changes in the cervical region begin to develop, what happens with osteochondrosis, osteophytes - bony growths, hernia in the cervical spine;
- if there are abnormalities in the development of the cervical vertebrae;
- when the channels through which the arteries pass are swollen, swelling, or inflamed surrounding tissues;
- in rare cases, the development of the process is affected by the unusual divergence of the arteries or the narrowing of the lumen of the vessels, which happens with atherosclerosis.
Symptoms of vertebral artery syndrome in many ways coincide with the common signs of osteochondrosis of this part of the spine, but there are significant differences. Arterial pressure can be unilateral, in rare cases on both sides, the flow and manifestation of the disease depend on this. The syndrome is characterized by the following changes in health status:
- severe headaches, which often appear with sharp turns of the head, are diffuse, paroxysmal or permanent;
- hearing loss on the affected side;
- marked dizziness during intense movements;
- is associated with a violation of eye nutrition, which causes a person to notice a decrease in visual acuity, flickering of flies before the eyes;
- short-term loss of consciousness;
- a violation of the sensitivity of the skin from the side of the lesion;
- sensation of a coma in the throat and sorrow, coughing.
The frequency and number of the above manifestations depend on the intensity of arterial damage.
With such complaints, a person will come to a neurologist or therapist. What is the basis of the diagnosis:
- complaints of a sick person;
- a crucial role in the diagnosis belongs to the functional methods of research: ultrasound of the vessels of the neck and brain, due to which it is possible to get a full picture of the structure of the arteries;
- X-ray examination, which helps to determine the presence of pathological growths of bone mass or changes in the bodies of the vertebrae of the neck;
- MRI is a very detailed picture of bones and soft tissues, which gives a full picture of the presence of formations.
syndrome After consultation of specialists, a full and comprehensive examination, a long-term complex treatment of vertebral artery syndrome with cervical osteochondrosis begins. It includes several key points:
- long-term use of medicines;
- lifestyle change, a small adjustment of the habitual way of life;
- full course of physiotherapy;
1 Causes of the disease
Vertebral arteries pass through openings in the transverse processes of the cervical vertebrae. In the cranial cavity, they connect to an artery, which is called basilar. Bony-cartilaginous growths, or spasmed muscle or disc herniation, can squeeze the vertebral artery, while violating the circulation in it. Symptoms of the disease:
- Headache. One of the brightest symptoms that indicates a disease. The pain in this case is excruciatingly burning or pulsing. It extends from the nape of the neck, to the temple and to the frontal region. Pain can be permanent, or worse during physical exertion. Often a dream in an uncomfortable position provokes an attack of severe cephalalgia. In some cases, you can find a comfortable position, in which the head temporarily ceases to hurt.
- Hearing impairment. The patient begins to hear noise, usually in one ear. This can be a rustling, hissing. Also, the patient's hearing is disturbed, usually he begins to hear badly in one ear.
- Vestibular disorders. The patient turns to the doctor with complaints of dizziness. It occurs when the head is raised up, while with atherosclerosis, dizziness is observed when the head is lowered. Also, the patient can often lose stability. When you turn the head of the patient can fall sharply, while remaining in consciousness and independently rising after a while.
- Visual impairment. With vertebral artery syndrome, visual acuity decreases, flies appear before the eyes, the patient can feel pain in the eye area. There may also be a feeling that the eyes are covered with sand. The disease can lead to a complete loss of vision.
- Manifestations of cardiac diseases, including chest pain, palpitations, transient ischemic attacks.
- Increased blood pressure.
- Violation of speech and swallowing, sensation in the throat of foreign body.
- Nausea and vomiting.
- With sudden movements of the head, the patient may lose consciousness. Recover after twenty minutes, while experiencing weakness and dizziness for a long time.
- In some cases, vegetative disorders may occur, the patient may experience attacks of severe hunger, thirst, sensation of chills or fever.
Before starting treatment, the physician should conduct an examination and analyze the symptoms of the disease.
- Need x-ray of the cervical spine in different projections.
- MRI of the spine and brain.
- Dopplerography of vessels of the neck and brain.
3 Medical measures
There are different methods that will help get rid of the disease. In severe cases, surgical intervention is indicated. Other treatment methods include:
- Periodic wearing of the collar of Shantz. It helps to get rid of the burden on the cervical spine.
- Physiotherapy. It includes electrophoresis, magnetotherapy, phonophoresis. Massage of the cervical spine.
- Manual therapy. The method is to give the spine the right position.
4 Medical therapy
In order to get rid of the vertebral artery syndrome with cervical osteochondrosis, complex treatment is necessary. In this case, prescribe drugs from different groups in order to normalize blood circulation, remove the inflammatory process, relax the muscles and restore the nervous system.
In parallel, external warming agents, such as pepper patches or mustard plasters, can be used. They need to be applied to the neck area, below the base of the skull. This must be done carefully, so as not to get burned.
Drugs that are prescribed for the treatment of the disease:
- Centralized muscle relaxants and myotropic drugs. They allow you to relax your muscles and relieve tension. To such medicines carry: Sirdalut, Midokalm, No-shpu, Drotaverin.
- Nootropic drugs that improve blood circulation: Thiocetam, Lucetam, Cerebrolysin, Actovegin, Ceregin, Ceraxon,
- They are necessary for the recovery of nerve fibers. The most commonly used thiamine chloride, pyridoxine chloride and cyanocobalamin.
- Antiaggregants. Preparations that dilute blood, they include Acetylsalicylic acid.
- Antihypertensive drugs. Assign as needed, with increased pressure.
- Antidepressants. Assign for sleep disorders.
- To eliminate the main cause of vertebral artery syndrome appoint:
- Non-steroidal anti-inflammatory drugs. The active ingredient of which can be diclofenac, nimesulide, ibuprofen, meloxicam, acyclofenac. They are prescribed both in the form of injections, and for internal reception, or externally in the form of ointments.
- Chondroprotectors. Allow to restore cartilaginous tissue. They need to take a long period of six months to one year. Use them in the form of ointments, capsules, tablets or injections. To such preparations carry: Teraflex, Don, Mukosat.
- Glucorticosteroids. These are hormonal drugs that are used to relieve the inflammatory process and for more effective work of non-steroids and muscle relaxants.
- For grinding, you can use tinctures that will have a distracting effect and improve blood circulation. These include Menovazine, Pepper Tincture, Formic Alcohol, Camphor Alcohol.
Dosage of medications and their form of release should be prescribed by a doctor after full consultation.
5 Folk methods
Camphor alcohol. For the preparation of rubbing, which will help get rid of pain in the neck and improve blood circulation, you will need camphor alcohol and ten tablets of Analgin. Tablets need to be ground into a powder and dissolved in alcohol. Apply to the neck area up to three times a day.
Therapeutic ointment. To prepare the ointment, you need a glass of refined sunflower oil, which needs to be heated in a water bath, add twenty grams of beeswax. Previously, you need to boil a fresh chicken egg, extract the yolk from it and cut it in half. Half yolk with a fork to mash.
In the boiling oil, add the yolk to the grains, as the product will foam strongly. Once it is ready, it must be filtered using a nylon fabric and add twenty milliliters of propolis tincture.
To prepare the tincture, you need ten grams of propolis, which is filled with fifty milliliters of medical alcohol. The agent is placed in a vial of dark glass and allowed to stand for a week, then filter.
Ready ointment should be stored in the refrigerator. It should be applied on a thick layer on three cotton fabrics and applied to the neck at the base of the skull, covered with polyethylene on top and wrapped in a warm scarf. Leave it overnight. In order for the effect of the procedure to be carried out daily for three weeks.
For treatment, you will need the roots of sunflower, which you need to dig up in the autumn, thoroughly washed and dried. Two cups of crushed roots should be filled with water and put on a small fire. Stir for 30 minutes, then allow to cool and drain.
You need a day to drink one liter of broth. It can be divided into several receptions or simply used instead of water. This agent helps to remove salts from the body and help get rid of cervical osteochondrosis and the associated spinal artery syndrome.
Hawthorn is used to improve blood circulation. A tablespoon of hawthorn fruit, pour half a liter of boiling water and allow to stand for forty minutes. Then the infusion should be filtered and used on a quarter cup to four times a day.
Horseradish pack has a warming effect and improves blood circulation in the neck area. For cooking, the root of horseradish should be thoroughly washed, grated or grinded with a meat grinder. On the neck you need to put a linen napkin( in order not to cause a burn), put a gruel on top and cover with cellophane. Then the neck should be wrapped in a woolen shawl and left for two hours.
If it seems to you that the burning sensation is not too strong, at the same time, a burn does not appear on the skin, the gruel can be applied without a napkin.
6 Exercises for vertebral artery syndrome
All exercises should be done smoothly, as a sharp movement can provoke a headache.
- You need to stand up straight, keep your legs together. Head the maximum leaning forward, pressing his chin. In this position, stand for five seconds, and return to the original.
- The head is tilted to the right as far as possible, and hold it for a few seconds, then rotate clockwise. Then head as much as possible to the left, and delay for the same period. Again, do a rotational motion and tilt the head forward, and after the next circle, tilt back.
- Standing straight, feet shoulder-width apart. We raise our hands and connect them with the back of our hands. We fix in this position for a few seconds, then we begin the turns of the trunk first to the left and then to the right. Each time you need to fix the position. Then the exercise is complicated, lifting first the left leg and then the right leg.
In order to properly diagnose vertebral artery syndrome with cervical osteochondrosis and prescribe timely treatment, it is necessary to consult a doctor.
Syndrome of vertebral artery: causes, symptoms, treatment, gymnastics and prevention
Syndrome of the vertebral artery is a nonspecific symptom complex that develops by squeezing the vertebral arteries or irritating the sympathetic plexus around them. This pathology was first described in 1925 by the doctors Barre and Liu. Headache, dizziness, fainting, moderate pain in the neck - these are some of the complaints of such patients. They arise because of a violation of the blood supply to the brain. Compression can be one-sided and two-sided.
Causes of vertebral artery syndrome
As is known, the vertebral artery is a paired vessel that departs from the subclavian artery and carries blood into the cranial cavity through a special channel formed by holes in the transverse processes of the thoracic vertebrae. So any narrowing of this channel leads to the development of the vertebral artery syndrome.
This pathology is very common, as a consequence of degenerative-dystrophic processes in the cervical spine, for example, in osteochondrosis, medial intervertebral hernia, spondylosis( formation of "bone growths" - osteophytes), arthrosis of small( uncovertebral) joints.
From rare causes of compression of the vertebral arteries, one can call an atypical variant of divergence from the subclavian artery, anomalies of the neck structure( additional cervical rib, Kimmery anomaly extra arch of the first cervical vertebra) and strongly expressed spasm of the neck muscles.
Syndrome of the vertebral artery: symptoms and diagnostics
For this pathology, the following non-specific symptoms are characteristic, that is, are not characteristic only for this disease:
- Pain of burning or pulsating nature is localized more often in the occipital region, irradiates to temples, parietal arches and brow ridges, is one-sided and two-sided. Most patients complain of persistent pain, worse after sleeping in an uncomfortable position, while walking or riding in any transport.
- Disturbance of hearing and vestibular analyzer functions is manifested in hearing loss, noise in the ears, dizziness, nausea and vomiting of the central genesis can be noted.
- Violation of the functions of the visual analyzer - reduced visual acuity, "sand in the eyes" or "fog before the eyes," pain in the eyes.
- Loss of consciousness.
- Pain in the heart that simulates ischemic disease or angina.
- Increased blood pressure.
- Feeling "lump in the throat".
- Falling after an awkward turn of the head without losing consciousness.
It is important to remember that all these symptoms of the vertebral artery syndrome are very similar to the symptoms of a stroke, so when these complaints occur, you should immediately consult a doctor.
Special diagnostic methods are used to diagnose the syndrome of the vertebral artery. Already during the examination, the neurologist can detect the limitation of movements in the cervical spine, the tension of the occipital muscles, soreness in palpation in the suboccipital region between the transverse processes of the atlas and the epistrophe( the first cervical vertebrae), focal symptomatology, and others. On the roentgenograms of the cervical spine, performed in two projections, the cause of the compression, for example, the osteophyte, can be detected. As a rule, in this pathology, dopplerography of the vessels of the head and neck is performed to evaluate the vertebrobasilar blood flow. An additional method of diagnosis is MRI( magnetic resonance imaging).
Video: "Vertebral artery syndrome or vertebrobasilar syndrome"
Basic methods of treatment
Treatment of vertebral artery syndrome depends on the cause, as some conditions require emergency hospitalization and even surgical intervention, such as in cervical intervertebral hernia with severe neurologic symptoms orwith acute disturbance of cerebral circulation in the vertebrobasilar basin.
Conservative treatment methods
If the compression of the vertebral artery is not critical and does not require in-patient treatment, then medicamental and manual methods are used.
- First of all, immobilization of the cervical spine is prescribed. Reduction in the load in this case is achieved by wearing a special orthopedic corset, which is called the collar of Shants.
- Pain syndrome is removed with anesthetic drugs from the group of NSAIDs( Diclofenac, Nyz) or muscle relaxants( Midokalm).
- To improve cerebral circulation and eliminate the consequences of ischemia, vasodilators are prescribed: Cavinton, Cinnarizin.
- Betagystine is a good aid for dizziness due to the effects on the nuclei of the vestibular analyzer located in the brain.
- To soften muscle tension and restore normal anatomical interrelations between the structural units of the neck, soft manual techniques( traction, post-isometric relaxation, etc.), osteopathic effect, acupuncture and physiotherapy( magnetotherapy, laser therapy, etc.) are used.
- An essential element in the complex of measures for vertebrogenic vertebral artery syndrome is exercise therapy. Gymnastics patient begins to deal with when they stop pain. The doctor selects special sparing exercises, allowing to strengthen the muscles of the neck.
Exercises for vertebral artery syndrome
- With this pathology it is very useful to do joint exercises for fingers. Various movements are carried out with each finger separately and with a brush as a whole( clenching and unclenching, while fingers are bred as widely as possible), rotational movements in wrist joints and self-massage of hands. These simple exercises cause an increase in blood flow in the vessels of the neck.
- Various movements in the elbow and shoulder joints: rotation, flexion - extension, reduction - withdrawal, exercises with a gymnastic stick and shock absorber.
- Since active movements in the cervical spine for this pathology are contraindicated, the strengthening of the muscles is carried out passively with the help of the so-called self-resistance exercise. Standing against the wall, press the back of the head on the wall for a few seconds, then relax. The same thing we repeat with the hand at the temple, at the forehead, etc.
- Swimming on the back and style of the crawl.
Consequences of vertebral artery syndrome
Inadequate treatment or non-treatment of the consequences can be very different: from deterioration to complete disability.
During the illness, two stages are distinguished:
- angiodystonic, in which the main symptoms are dizziness, severe headaches, nausea and vomiting;
- is ischemic, characterized by severe impairment of cerebral circulation, weakness, deterioration of general condition, impaired sensation and coordination.
In a consequence, a stroke can develop, as well as damage to the spinal cord. The patient loses the ability to work and self-service.
- Regular execution of special exercises that form a muscular corset. During the working day, you should take breaks every hour and knead the tired muscles of the shoulder girdle, as well as perform simple movements: head inclinations and turns. This will relieve muscle tension and improve cerebral circulation.
- For sleep, you should purchase an orthopedic pillow. Sleep better on your back or side, on your stomach is not allowed to sleep. In this case, the head should not be thrown back.
- Preventative massage courses 1-2 times a year.
- Sanatorium treatment.
To understand the mechanism of the influence of osteochondrosis on the vertebral artery is easy enough if you become acquainted with the peculiarities of the location of the artery itself.
This blood vessel is a paired structure: branching from the subclavian arteries, it enters the sixth vertebra from the side and then rises up the canal formed by the remaining cervical vertebrae, and is sent to the cavity of the skull.
Thus, on the way of its passage, the arteries are contacted both with the vertebral column itself and with soft tissues that are adjacent to it.
Now it is easy to imagine the state of these blood vessels lying in the cervical region affected by osteochondrosis. The intervertebral discs are compacted, as a result of which the vertebrae "sag", move relative to each other, deforming the lumen of the canal in which the arteries pass.
The swelling and spasms characteristic of this disease also do not alleviate the task for an artery that must supply blood to the brain. Compression of its walls leads to insufficient supply of brain oxygen and nutrients, which provokes the development of a number of symptoms.
But vascular problems are not the only ones with this syndrome. The vertebral artery is flanked by the sympathetic nervous complex, and its infringement occurs simultaneously with the squeezing of the vessels, which leads to the appearance of neurological symptoms.
In fact, with cervical osteochondrosis, only one condition is necessary for the development of the vertebral artery syndrome: osteochondrosis proper.
But a number of factors can aggravate the severity of vertebral pathologies and, accordingly, increase the negative effect on the arteries and sympathetic nervous complex:
- bad habits( smoking, alcohol abuse);
- systemic diseases caused or accompanied by circulatory disorders( atherosclerosis, diabetes mellitus, etc.);
- excessive physical and psychoemotional loads;
- is a hereditary predisposition to vascular disorders.
About 40% of cases of vertebral artery syndrome are caused by congenital abnormalities of the structure and / or topography of arteries or individual features of the structure of the vertebrae themselves. It can be pathological bends of one or two vessels, the so-called "pockets" on their walls, etc.
Important: Atherosclerosis itself narrows the lumen of blood vessels, and in combination with cervical osteochondrosis, this disease can cause rapid development of neurologic symptoms, and also, without treatment, significantly worsen the prognosis for recovery.
Symptoms of the syndrome are vascular and neurological in nature - this is due to the effect of osteochondrosis on blood vessels and nerve plexuses.
In addition, the vertebral arteries, merging in the cranial cavity into one large, basilar, nourish important parts of the brain: the cerebellum, trunk, temporal lobes, inner ear and cranial nerves.
This makes it clear that the syndrome has characteristic "brain" manifestations and symptoms, which most often develop in a complex way:
- Headache, predominantly one-sided and permanent. Pain syndrome is a type of ripple or burning, patients often describe the pain as unbearable, painful. Sensations increase after some time spent with the head thrown back( for example, in a dream), walking, running. Clear pain syndrome has no localization and is perceived as chaotic splashes of pain in the brow, temples, crown of the head. One of the characteristic signs of pain in the syndrome of the vertebral artery is the ability to find the position of the head, in which pain can not only weaken, but also completely disappear. This is due to the fact that in a certain position of the cervical vertebrae the pressure on the sympathetic nervous complex is eliminated.
- Numbness of any part of the face. The zone of numbness and the degree of preserved sensitivity depend on how much the circulation of the cranial nerves is reduced. Often, this symptom leads to a stable asymmetry of the facial features, most often the omission of one of the corners of the mouth occurs.
- Vestibular disorders. Dizziness, sudden loss of feeling in space, a disturbance of the sense of balance can occur even with the most minor actions - turning the head, translating the view from a nearby object to a distant one, etc. One of the vestibular disorders, which are often mistaken for symptoms of the digestive tract, include severe nauseaand vomiting( often indomitable), after which the patient does not experience relief. Such symptoms are most often observed with a sharp change in the position of the head - turning to the side, dropping down.
- Auditory disorders. Subjective noise and ringing in the ears are caused by insufficient blood supply to the brain region responsible for the analysis of electrical signals coming from the auditory nerve. The nerve itself also suffers from poor blood supply and, in the absence of treatment for the syndrome, acuity of hearing is inevitably reduced.
- Spotting disorders. Sensation of film or sand in the eyes, the appearance in the field of vision of "flies" and dark spots, an apparent reduction in visual acuity, not associated with visual stress or prolonged work at the computer.
- Cardiovascular disorders. With the syndrome of the vertebral artery, the patient often experiences symptoms that mimic cardiac arrhythmias-heart palpitations, chest pain, a feeling of lack of air during inspiration.
- Psychological disorders. In this state, patients often experience attacks of panic attack, unreasonable irritability and aggression, cases of depressive conditions that are caused by constant pains, fatigue, inability to concentrate and concentrate attention, decrease in cognitive abilities are not uncommon.
- The loss of consciousness, which can become a life threatening condition, is often preceded by a prolonged deflection of the head back - a position that a person takes, for example, looking up for a long time. In this position with cervical osteochondrosis, vertebral arteries can be completely compressed, and the blood supply to the brain continues only at the expense of the carotid arteries: the supply of oxygen and nutrients to the brain is only 65-80% of the required amount. Before the loss of consciousness associated with complete compression of vertebral arteries, there may be:
- severe dizziness accompanied by nausea;
- speech disorders( slurred pronunciation, difficulties with the formation of phrases, etc.);
- sensation of loss of soil underfoot( often described by patients as "floating floor");
- sudden loss of vision in one eye( after fainting passed, vision restored).
Important: The described symptoms may be evidence of acute impairment of cerebral circulation or cerebral edema that develop with stroke, meningitis, etc., and may also be signs of brain damage.
Both conditions require emergency medical attention, so if there is even one of these symptoms, especially if their occurrence is sudden, contact your doctor immediately.
How the doctor makes this diagnosis
The doctor may presume the presence of vertebral artery syndrome based on the patient's complaints. If at the same time in the outpatient card there are records of a diagnosed osteochondrosis of the cervical department - the diagnosis can be considered refined.
The main task of diagnosis in this syndrome is the detailing of the condition of the vertebral artery, for which a set of instrumental and laboratory studies is assigned. For the diagnosis can be assigned CT, MRI, contrast radiography, Doppler study and blood tests, helping to assess the quality of oxygen transportation and the presence of possible co-morbidities.
Since this syndrome is often a violation of the cardiovascular system, the appointment of diagnostic procedures can be attended by a cardiologist. In this case, daily monitoring of blood pressure, ECG, phonocardiogram, etc. is recommended.
Important: Older people, as well as their family members, often refer changes in the behavior and reactions of the patient to age-related cognitive impairment and do not seek medical attention, considering these signs natural forold age and not amenable to treatment. Misconceptions about the nature of such symptoms are the cause of the loss of precious time, which can be used to treat and restore the quality of human life.
In the absence of treatment, the syndrome of the vertebral artery carries a serious threat not only to health, but also to human life. As osteochondrosis progresses, pressure on the arteries and sympathetic complex increases, which can cause acute circulatory disturbances in the brain, cardiac and respiratory failure, complete loss of sight and hearing.
Due to the severity of possible complications, treatment requires mandatory monitoring and supervision by a qualified specialist.
Treatment of the syndrome is aimed at restoring the blood supply to the brain, removing the pain syndrome and preventing complications that are characteristic of this syndrome.
Drug therapy uses the principle of an integrated approach, in which the drugs are selected taking into account the general health of the patient, the presence of concomitant diseases, the severity of the symptoms, etc. The basic treatment regimen uses the following groups of drugs:
- anti-inflammatory( Nimesulide, Celebrex, Movalis);
- improving cerebral circulation and microcirculation( Cinnarizine, Pyracetam, Thiocetam);
- normalizing the arterial blood flow( Trental, Agapurin);
- improving venous outflow( Troxerutin, Diosmin);
- neuroprotective action( Somazin, Sermion).
Depending on the results of instrumental and laboratory studies, muscle relaxants, hypoxia-eliminating drugs, bioactive agents and many others can be prescribed. The combination of medications depends on the manifestation of the syndrome, the degree of disruption of the blood supply to the brain, and the compression of the arteries and sympathetic complex and other factors.
As with all diseases associated with spine pathologies, physiotherapy is used exclusively outside the period of exacerbation and only as an auxiliary treatment.
Given that the vertebral artery undergoes constant compression by vertebrae, the massage of the collar zone can be contraindicated even during remission( the decision remains with the attending physician, who takes into account the peculiarities of the syndrome in each case).
The primary method of treatment is acupuncture and acupuncture, which allows you to remove muscle spasms and weaken the pain syndrome, as well as squeezing the arteries and the nerve plexus with strained muscle fibers.
All surgical procedures on the spine are performed only on strict indications:
- episodes of acute cerebrovascular accident caused by compression of vertebral arteries;
- cognitive impairment due to insufficient blood supply to the brain;
- vertebral artery syndrome, accompanied by a high degree of arterial hypertension, atherosclerosis or congenital abnormalities of the structure or topography of vertebral arteries;
- rapid progression of visual, auditory and vestibular disorders;
- no effect with other treatment methods.
Important: in case of vertebral artery syndrome, the patient should take a direct part in the treatment process: adjust his lifestyle and diet, do not stop wearing the collar of Shantz( mandatory appointment in this pathology) and follow the doctor's recommendations exactly. Only the well-coordinated work of the tandem "doctor-patient" can become a guarantee of getting rid of this disease.
How to live with a syndrome of the vertebral artery
What office worker did not complain about pain in the neck? They worry both students sitting in a fixed position in lectures, and older people. The trouble is that changes in the cervical vertebrae do not wait for old age and arise in the young. Syndrome of the vertebral artery is a variant of the clinical course of cervical osteochondrosis.
In addition to the violation of the osseous structure of the vertebrae, the causes of cervical osteochondrosis are hidden in birth traumas( this department of the spine of the child carries the maximum load in childbirth), the forced position of the body, and the lack of development of the muscular skeleton of the neck.
What does the vertebral artery have?
Seven cervical vertebrae perform a load to provide mobility and support the head and neck much larger than the lumbar spine.
Spinal processes of 3-7 vertebrae connecting form on each side mobile bone channels for passage of the vertebral artery. The presence of such strengthened protection proves the importance of this vessel for the organism.
Two thin branches branch off from the left and right subclavian arteries and carry blood up to the brain. Along the way, we intertwine with the sympathetic nerve. At the base of the skull they merge and form a ring, from which the vessels emerge to the brain stem, temporal lobes, cerebellum, inner ear, nourish the tissue of important cranial nerves.
Any violations of the patency of the arteries affect the blood supply to the brain, their functioning. Insufficient nutrition of the cranial nerves leads to a deterioration of innervation of internal organs and can cause pathological changes.
What happens with osteochondrosis?
The cause of artery damage in cervical osteochondrosis is called vertebrogenic, depending on the vertebrae. The destruction of the bony canal, the displacement of the vertebrae lead to the squeezing of the vessel, therefore, the nutrition of the brain structures to which it is directed is disturbed.
Similar changes occur after trauma, hypothermia of the neck, accompanying the curve. The pathological mechanism is aggravated by swelling of the tissues and muscle spasm.
Symptoms of the disease are of considerable concern to patients. The severity of clinical manifestations must always be distinguished from hypertensive disease, exclude neoplasms in the brain, and strokes.
- Headaches are one of the main components of the syndrome. They can be blunt, sharp, pulsating, bursting. Localize in the nape, in the temporal region. Often the patient connects the onset of pain with an uncomfortable posture during sleep, a prolonged involuntary immobile condition of the neck, a draft, a neck injury. There is pain in one half of the head. The duration varies from a few minutes to a day. With palpation of the spinous processes of the cervical vertebrae, soreness and tension in the muscles are determined.
- Vertigo - appears in the morning after sleeping on a high pillow. Accompanied by impaired vision, noise in the ears, hearing loss. Characteristic improvement after wearing the collar of Shantz, which provides restriction of movement of the cervical spine. This method is used for differential diagnosis with a different pathology.
- Nausea - It is noted that nausea and vomiting often occur before a headache attack. They are not associated with intracranial pressure.
- Noise in the ears - occurs at night, closer to the morning. Can be felt in one ear or both. It changes in timbre and constancy. Depends on the position of the head. Turns to the side cause increased noise.
- Loss of sensitivity or numbness - occurs on the skin around the mouth, cheekbones, temples, on the surface of the neck, on the hands.
- Fainting - loss of consciousness is associated with a prolonged presence in the position of extension of the head back. In this situation, the nutrition of the entire vertebro-basilar system is severely disrupted, the brain structures suffer. Through the vertebral arteries, up to 30% of the brain volume is supplied( the other parts are fed from the carotid arteries).Even a drop in blood flow of less than 1/3 causes dizziness, a shaky gait, a loss of sensitivity, a decrease in vision to unstable blindness in one eye, a loss of ability to speak.
A prolonged course of the disease adds to the spinal artery syndrome changes in the psyche. There is a decrease in memory, learning impairment, depression. The patient is tired of constant exhausting headaches, has a tendency to suicide( suicide).
More rare manifestations of the vertebral artery syndrome are fluctuations in blood pressure, pain in the shoulder and arm on the one hand, and heart rhythm disturbances. Such changes are associated with simultaneous irritation of the sympathetic nerve.
The diagnosis requires an experienced therapist and neurologist. Comparison of clinical symptoms with painful palpation of the vertebrae of the neck causes the patient to be referred to an X-ray study.
Radiography of the cervical spine allows detecting bone abnormalities of the canal of the vertebral artery.
ultrasound and dopplerography determine the degree of disturbed blood flow from both sides, show an artery widening, a compression site, a blood speed, a violation of patency.
Magnetoresonance tomography helps to exclude brain damage, reveals ischemic foci in tissues, cysts.
Cervical stretching is necessary to stop deformation of the bone channel. For this purpose, it is mandatory to wear the collar of Shantz. He is selected individually for neck sizes in orthopedic stores.
- To prevent and relieve pain, Nimesulide, Ibuprofen are recommended( they have analgesic and anti-inflammatory effects);
- shows preparations that improve the permeability of vessels, venous outflow;
- to protect and replenish the supply of brain tissue prescribed sets of vitamins and amino acids, nootropics, antioxidants;
- dizziness relieves tablets based on atropine.
Physiotherapy advises slow nodding movements, slopes to the side. They are necessary for the development of the supporting muscles of the neck. Exercises for cervical osteochondrosis should also be done correctly!
A person with vertebral artery syndrome should necessarily arrange a physical workout during the working day, massage the upper muscles of the shoulder girdle and neck.
Successfully treated the disease with acupuncture and also physiotherapy techniques: galvanization, magnetotherapy, ultrasound procedures, laser therapy.
In the hydropathic institutions the method of stretching in the pool is used. Mud applications with natural bioactive substances help restore metabolic disturbances in the vertebrae.
The observation of patients with vertebral artery syndrome is performed by a neurologist and a district therapist. Treatment procedures must be conducted in courses. This ensures continued active life.