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Vertebrobasilar insufficiency

MedGen UID:
12075
•Concept ID:
C0042568
•
Disease or Syndrome
Synonyms: Insufficiencies, Vertebro-Basilar; Insufficiencies, Vertebrobasilar; Insufficiency, Vertebro-Basilar; Insufficiency, Vertebrobasilar; Ischemia, Vertebro-Basilar; Ischemia, Vertebrobasilar; Ischemias, Vertebro-Basilar; Ischemias, Vertebrobasilar; Vertebro Basilar Insufficiency; Vertebro Basilar Ischemia; Vertebro-Basilar Insufficiencies; Vertebro-Basilar Insufficiency; Vertebro-Basilar Ischemia; Vertebro-Basilar Ischemias; Vertebrobasilar Insufficiencies; Vertebrobasilar Insufficiency; Vertebrobasilar Ischemia; Vertebrobasilar Ischemias
SNOMED CT: Vertebrobasilar arterial insufficiency (64009001); Vertebrobasilar insufficiency (64009001); Vertebrobasilar artery syndrome (195199008)
 
Monarch Initiative: MONDO:0001613

Definition

Localized or diffuse reduction in blood flow through the vertebrobasilar arterial system, which supplies the brain stem; cerebellum; occipital lobe; medial temporal lobe; and thalamus. Characteristic clinical features include syncope; lightheadedness; visual disturbances; and vertigo. brain stem infarctions or other brain infarction may be associated. [from MONDO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVVertebrobasilar insufficiency

Professional guidelines

PubMed

Mechanical Thrombectomy for Tandem Vertebrobasilar Stroke: Characteristics and Treatment Outcome.
Baik SH, Jung C, Kim BM, Kim DJ
Stroke 2020 Jun;51(6):1883-1885. Epub 2020 May 14 doi: 10.1161/STROKEAHA.120.029503. PMID: 32404041
Endovascular Treatment of Vertebral Artery Stenosis.
Jenkins JS, Stewart M
Prog Cardiovasc Dis 2017 May-Jun;59(6):619-625. Epub 2017 Mar 8 doi: 10.1016/j.pcad.2017.02.005. PMID: 28284683
Vertebrobasilar insufficiency. Part 2. Microsurgical treatment of intracranial vertebrobasilar disease.
Hopkins LN, Martin NA, Hadley MN, Spetzler RF, Budny J, Carter LP
J Neurosurg 1987 May;66(5):662-74. doi: 10.3171/jns.1987.66.5.0662. PMID: 3553454

Recent clinical studies

Etiology

"Dolichoectatic Vertebrobasilar Artery Aneurysms".
Rezai Jahromi B, Niemelä M
Neurosurg Clin N Am 2022 Oct;33(4):419-429. Epub 2022 Sep 11 doi: 10.1016/j.nec.2022.06.003. PMID: 36229129
Posterior Circulation Ischaemic Stroke.
Ng AC
Am J Med Sci 2022 May;363(5):388-398. Epub 2022 Jan 31 doi: 10.1016/j.amjms.2021.10.027. PMID: 35104439
Patterns of ischemic posterior circulation strokes: A clinical, anatomical, and radiological review.
Salerno A, Strambo D, Nannoni S, Dunet V, Michel P
Int J Stroke 2022 Aug;17(7):714-722. Epub 2021 Sep 28 doi: 10.1177/17474930211046758. PMID: 34581223Free PMC Article
Vertebral artery stenosis.
Madonis SM, Jenkins JS
Prog Cardiovasc Dis 2021 Mar-Apr;65:55-59. Epub 2021 Feb 14 doi: 10.1016/j.pcad.2021.02.006. PMID: 33592207
Endovascular Treatment of Vertebral Artery Stenosis.
Jenkins JS, Stewart M
Prog Cardiovasc Dis 2017 May-Jun;59(6):619-625. Epub 2017 Mar 8 doi: 10.1016/j.pcad.2017.02.005. PMID: 28284683

Diagnosis

Bow Hunter's Syndrome.
Regenhardt RW, Kozberg MG, Dmytriw AA, Vranic JE, Stapleton CJ, Silverman SB, Patel AB
Stroke 2022 Jan;53(1):e26-e29. Epub 2021 Dec 6 doi: 10.1161/STROKEAHA.121.037253. PMID: 34865507Free PMC Article
Patterns of ischemic posterior circulation strokes: A clinical, anatomical, and radiological review.
Salerno A, Strambo D, Nannoni S, Dunet V, Michel P
Int J Stroke 2022 Aug;17(7):714-722. Epub 2021 Sep 28 doi: 10.1177/17474930211046758. PMID: 34581223Free PMC Article
Positional Vertigo.
Yellin I, Svrakic M
Otolaryngol Clin North Am 2021 Oct;54(5):913-924. Epub 2021 Jul 20 doi: 10.1016/j.otc.2021.05.012. PMID: 34294440
Vertebral artery stenosis.
Madonis SM, Jenkins JS
Prog Cardiovasc Dis 2021 Mar-Apr;65:55-59. Epub 2021 Feb 14 doi: 10.1016/j.pcad.2021.02.006. PMID: 33592207
Posterior circulation ischaemic stroke-a review part I: anatomy, aetiology and clinical presentations.
Sparaco M, Ciolli L, Zini A
Neurol Sci 2019 Oct;40(10):1995-2006. Epub 2019 Jun 20 doi: 10.1007/s10072-019-03977-2. PMID: 31222544

Therapy

Treatment of posterior circulation stroke: Acute management and secondary prevention.
Markus HS, Michel P
Int J Stroke 2022 Aug;17(7):723-732. Epub 2022 Jun 28 doi: 10.1177/17474930221107500. PMID: 35658624Free PMC Article
Posterior Circulation Ischaemic Stroke.
Ng AC
Am J Med Sci 2022 May;363(5):388-398. Epub 2022 Jan 31 doi: 10.1016/j.amjms.2021.10.027. PMID: 35104439
Endovascular Therapy for Stroke Due to Basilar-Artery Occlusion.
Langezaal LCM, van der Hoeven EJRJ, Mont'Alverne FJA, de Carvalho JJF, Lima FO, Dippel DWJ, van der Lugt A, Lo RTH, Boiten J, Lycklama À Nijeholt GJ, Staals J, van Zwam WH, Nederkoorn PJ, Majoie CBLM, Gerber JC, Mazighi M, Piotin M, Zini A, Vallone S, Hofmeijer J, Martins SO, Nolte CH, Szabo K, Dias FA, Abud DG, Wermer MJH, Remmers MJM, Schneider H, Rueckert CM, de Laat KF, Yoo AJ, van Doormaal PJ, van Es ACGM, Emmer BJ, Michel P, Puetz V, Audebert HJ, Pontes-Neto OM, Vos JA, Kappelle LJ, Algra A, Schonewille WJ; BASICS Study Group
N Engl J Med 2021 May 20;384(20):1910-1920. doi: 10.1056/NEJMoa2030297. PMID: 34010530
Vertebral artery stenosis.
Madonis SM, Jenkins JS
Prog Cardiovasc Dis 2021 Mar-Apr;65:55-59. Epub 2021 Feb 14 doi: 10.1016/j.pcad.2021.02.006. PMID: 33592207
Effect of cervical manipulation on vertebral artery and cerebral haemodynamics in patients with chronic neck pain: a crossover randomised controlled trial.
Moser N, Mior S, Noseworthy M, Côté P, Wells G, Behr M, Triano J
BMJ Open 2019 May 28;9(5):e025219. doi: 10.1136/bmjopen-2018-025219. PMID: 31142519Free PMC Article

Prognosis

Patterns of ischemic posterior circulation strokes: A clinical, anatomical, and radiological review.
Salerno A, Strambo D, Nannoni S, Dunet V, Michel P
Int J Stroke 2022 Aug;17(7):714-722. Epub 2021 Sep 28 doi: 10.1177/17474930211046758. PMID: 34581223Free PMC Article
Vertebral artery loops in surgical perspective.
Ekşi MŞ, Toktaş ZO, Yılmaz B, Demir MK, Özcan-Ekşi EE, Bayoumi AB, Yener Y, Akakın A, Konya D
Eur Spine J 2016 Dec;25(12):4171-4180. Epub 2016 Jul 7 doi: 10.1007/s00586-016-4691-1. PMID: 27388018
Radial Artery Bypass for Intractable Vertebrobasilar Insufficiency: Case Series and Review of the Literature.
Britz GW, Agarwal V, Mihlon F, Ramanathan D, Agrawal A, Nimjee SM, Kaylie D
World Neurosurg 2016 Jan;85:106-13. Epub 2015 Aug 15 doi: 10.1016/j.wneu.2015.08.004. PMID: 26284960
Research progress on vertebrobasilar dolichoectasia.
Yuan YJ, Xu K, Luo Q, Yu JL
Int J Med Sci 2014;11(10):1039-48. Epub 2014 Aug 2 doi: 10.7150/ijms.8566. PMID: 25136259Free PMC Article
Non-saccular vertebrobasilar aneurysms and dolichoectasia: a systematic literature review.
Shapiro M, Becske T, Riina HA, Raz E, Zumofen D, Nelson PK
J Neurointerv Surg 2014 Jun;6(5):389-93. Epub 2013 Jul 10 doi: 10.1136/neurintsurg-2013-010793. PMID: 23843444

Clinical prediction guides

Posterior Circulation Ischaemic Stroke.
Ng AC
Am J Med Sci 2022 May;363(5):388-398. Epub 2022 Jan 31 doi: 10.1016/j.amjms.2021.10.027. PMID: 35104439
Effect of cervical manipulation on vertebral artery and cerebral haemodynamics in patients with chronic neck pain: a crossover randomised controlled trial.
Moser N, Mior S, Noseworthy M, Côté P, Wells G, Behr M, Triano J
BMJ Open 2019 May 28;9(5):e025219. doi: 10.1136/bmjopen-2018-025219. PMID: 31142519Free PMC Article
Clinical investigation and characterization of vertebrobasilar dolichoectasia and vertebral artery dominance.
Meng X, Ding W, Wu X, Di P
Discov Med 2018 Apr;25(138):151-158. PMID: 29723487
Multimodality Imaging of Vertebrobasilar Dolichoectasia: Clinical Presentations and Imaging Spectrum.
Samim M, Goldstein A, Schindler J, Johnson MH
Radiographics 2016 Jul-Aug;36(4):1129-46. Epub 2016 Jun 17 doi: 10.1148/rg.2016150032. PMID: 27315445
Non-saccular vertebrobasilar aneurysms and dolichoectasia: a systematic literature review.
Shapiro M, Becske T, Riina HA, Raz E, Zumofen D, Nelson PK
J Neurointerv Surg 2014 Jun;6(5):389-93. Epub 2013 Jul 10 doi: 10.1136/neurintsurg-2013-010793. PMID: 23843444

Recent systematic reviews

The effect of chinese herbal medicine Banxia Baizhu Tianma Decoction for the treatment of vertebrobasilar insufficiency vertigo: A systematic review and meta-analysis of randomized controlled trials.
Guo Z, Su Z, Wang Z, Luo X, Lai R
Complement Ther Med 2017 Apr;31:27-38. Epub 2017 Jan 20 doi: 10.1016/j.ctim.2017.01.004. PMID: 28434468
Non-saccular vertebrobasilar aneurysms and dolichoectasia: a systematic literature review.
Shapiro M, Becske T, Riina HA, Raz E, Zumofen D, Nelson PK
J Neurointerv Surg 2014 Jun;6(5):389-93. Epub 2013 Jul 10 doi: 10.1136/neurintsurg-2013-010793. PMID: 23843444
Clinical course and treatment of vertebrobasilar dolichoectasia: a systematic review of the literature.
Wolters FJ, Rinkel GJ, Vergouwen MD
Neurol Res 2013 Mar;35(2):131-7. doi: 10.1179/1743132812Y.0000000149. PMID: 23452575
Diagnostic accuracy of premanipulative vertebrobasilar insufficiency tests: a systematic review.
Hutting N, Verhagen AP, Vijverman V, Keesenberg MD, Dixon G, Scholten-Peeters GG
Man Ther 2013 Jun;18(3):177-82. Epub 2012 Nov 3 doi: 10.1016/j.math.2012.09.009. PMID: 23127991
Subclavian carotid transposition and bypass grafting: consecutive cohort study and systematic review.
Cinà CS, Safar HA, Laganà A, Arena G, Clase CM
J Vasc Surg 2002 Mar;35(3):422-9. doi: 10.1067/mva.2002.120035. PMID: 11877687

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