Vertebrobasilar Insufficiency

Publication Title: 
Voprosy Kurortologii, Fizioterapii, I Lechebnoĭ Fizicheskoĭ Kultury

Clinical and instrumental studies have revealed differences in effects of nerve ending and classic massage on hemodynamics in 41 patients early after transitory ischemic attacks in the vertebrobasilar area. Point massage produced more potent vasotropic effect, contraindications to it are minimal. It can be considered as a pathogenetic therapy aimed at correction of cerebral circulation in patients with vertebrobasilar area applicable early after acute cerebrovascular episodes.

Author(s): 
Gusarova, S. A.
Kuznetsov, O. F.
Gorbunov, F. E.
Maslovskaia, S. G.
Publication Title: 
Voprosy Kurortologii, Fizioterapii, I Lechebnoĭ Fizicheskoĭ Kultury

The present study included 65 patients presenting with vertebrogenic cerebral dyscirculation and degenerative change within the cervical spine in the absence of hemodynamically and/or morphologically significant lesions in brachiocephalic arteries. During the first phase of the study, 39 randomly selected patients underwent traction of the cervical spine following collar zone massage. Moreover, they were instructed to simultaneously wear a soft cervical collar.

Author(s): 
Sidorov, V. D.
Likhachev, M. Iu
Publication Title: 
Southern Medical Journal

A case of brain stem infarction after chiropractic manipulation of the cervical spine is presented. Proposed mechanisms and sites of possible arterial injury are discussed. A diagnosis of vertebral artery occlusion was made using conventional brachial angiography. Digital intravenous angiography, a relatively new and less invasive vascular imaging technique which was used as an adjunct for evaluating the remainder of the cervicocephalic vessels, documented the vertebral occlusion.

Author(s): 
Braun, I. F.
Pinto, R. S.
De Filipp, G. J.
Lieberman, A.
Pasternack, P.
Zimmerman, R. D.
Publication Title: 
Deutsche Medizinische Wochenschrift (1946)

In a 37-year-old female patient complaining of increasing pain in the neck and occiput, chiropractic manipulations at the cervical vertebral column were associated with ischaemias of the brain stem presenting as vertigo, transient "locked-in" syndrome followed by vomiting, and sensorimotor hemiparesis. Digital subtraction angiography (DSA) revealed complete obstruction of the right and slight dissection of the left vertebral artery. The symptoms receded within a few days after heparinisation with 1000 IU/h intravenously.

Author(s): 
Krieger, D.
Leibold, M.
Brückmann, H.
Publication Title: 
Angiology

Four patients undergoing cervical spinal manipulations for nonneurologic diseases and with no previous neurologic signs or symptoms all developed significant neurologic deficits, one fatal, following manipulations of the cervical spine. Both the literature and the authors' series show that a number of patients have a prodrome prior to the onset of neurologic changes. There is no established therapy for the syndrome. Perhaps prevention is the best means of reducing neurologic injury.

Author(s): 
Raskind, R.
North, C. M.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

OBJECTIVE: To determine the validity of the neck extension-rotation test as a clinical screening procedure to detect decreased vertebrobasilar blood flow that might be associated with dizziness. DESIGN: Secondary analysis of a clinical screening test. METHODS: Twelve subjects with dizziness reproduced by the extension-rotation test and 30 healthy control subjects had Doppler ultrasonography examination of their vertebral arteries with the neck extended and rotated. Vascular impedance to blood flow was measured and the presence of signs and symptoms of vertebrobasilar ischemia was recorded.

Author(s): 
Côté, P.
Kreitz, B. G.
Cassidy, J. D.
Thiel, H.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

OBJECTIVE: This article specifically addresses the question of whether the manipulable cervical lesion is likely to cause extrinsic compression of the vertebral arteries sufficient to cause such symptoms of reduced regional cerebral blood flow as might be relieved by spinal manipulation. DATA SOURCES: Literature on normal and abnormal cerebral circulation, including vertebrobasilar insufficiency.

Author(s): 
Budgell, B. S.
Sato, A.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

BACKGROUND: Several studies have been published on the effect of cervical rotation alone upon blood flow in the vertebral arteries. However, we have not found articles addressing the question of how spinal manipulative therapy per se affects the vertebral artery flow. OBJECTIVE: The aim of the present study was to investigate whether any changes occur in peak flow velocity in the vertebral artery after spinal manipulative therapy as measured using the latest Doppler ultrasound technology.

Author(s): 
Licht, P. B.
Christensen, H. W.
Højgaard, P.
Marving, J.
Publication Title: 
Neurosurgical Review

A 50-year-old woman presented a sudden left occipital headache and a posterior circulation stroke after cervical manipulation for neck pain. Magnetic resonance imaging documented a left intracranial vertebral artery occlusive dissection associated with an ipsilateral internal carotid artery dissection with vessel stenosis in its prepetrous tract. This is the first reported case showing an associate vertebral and carotid artery dissection following cervical manipulation. Carotid dissection was asymptomatic and, therefore, its incidence may be underestimated.

Author(s): 
Parenti, G.
Orlandi, G.
Bianchi, M.
Renna, M.
Martini, A.
Murri, L.
Publication Title: 
Neurologia Medico-Chirurgica

A 57-year-old male presented with a rare case of spontaneous vertebral arteriovenous fistula manifesting as radiculopathy of the right arm, subsequently associated with pulsating tinnitus and vascular bruit in the nape. He had a past history of chiropractic-induced vertebrobasilar infarction. Angiography showed a simple and direct fistula between the third segment of the right vertebral artery and the epidural veins at the C-1 level, where the artery runs backward above the arch of the C-1 just proximal to the penetration of the dura.

Author(s): 
Yoshida, S.
Nakazawa, K.
Oda, Y.

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