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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

Perspectives of Emergency Physicians, Primary Care Physicians, and Otolaryngologists on the Diagnosis and Treatment of Acute Vertigo.
Dede MN, Başoğlu Y, Yilmaz B, Şerbetçioğlu MB
Am J Audiol 2023 Jun;32(2):289-302. Epub 2023 Mar 30 doi: 10.1044/2022_AJA-22-00146. PMID: 36995903
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

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
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
Basilar artery occlusion.
Mattle HP, Arnold M, Lindsberg PJ, Schonewille WJ, Schroth G
Lancet Neurol 2011 Nov;10(11):1002-14. doi: 10.1016/S1474-4422(11)70229-0. PMID: 22014435
Sudden deafness.
Mort DJ, Bronstein AM
Curr Opin Neurol 2006 Feb;19(1):1-3. doi: 10.1097/01.wco.0000196155.92856.a1. PMID: 16415670

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
Endovascular treatment versus standard medical treatment for vertebrobasilar artery occlusion (BEST): an open-label, randomised controlled trial.
Liu X, Dai Q, Ye R, Zi W, Liu Y, Wang H, Zhu W, Ma M, Yin Q, Li M, Fan X, Sun W, Han Y, Lv Q, Liu R, Yang D, Shi Z, Zheng D, Deng X, Wan Y, Wang Z, Geng Y, Chen X, Zhou Z, Liao G, Jin P, Liu Y, Liu X, Zhang M, Zhou F, Shi H, Zhang Y, Guo F, Yin C, Niu G, Zhang M, Cai X, Zhu Q, Chen Z, Liang Y, Li B, Lin M, Wang W, Xu H, Fu X, Liu W, Tian X, Gong Z, Shi H, Wang C, Lv P, Tao Z, Zhu L, Yang S, Hu W, Jiang P, Liebeskind DS, Pereira VM, Leung T, Yan B, Davis S, Xu G, Nogueira RG; BEST Trial Investigators
Lancet Neurol 2020 Feb;19(2):115-122. Epub 2019 Dec 9 doi: 10.1016/S1474-4422(19)30395-3. PMID: 31831388

Prognosis

Vertebral Artery Interventions: A Comprehensive Updated Review.
Maitas O, Bob-Manuel T, Price J, Noor A, Obi K, Okoh N, Garikapati K, Kim J, Jahan S, Jenkins JS
Curr Cardiol Rev 2023;19(1):e170322202296. doi: 10.2174/1573403X18666220317093131. PMID: 35301953Free PMC Article
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
Vertebrobasilar disease.
Savitz SI, Caplan LR
N Engl J Med 2005 Jun 23;352(25):2618-26. doi: 10.1056/NEJMra041544. PMID: 15972868
Reoperative carotid surgery.
Kazmers A, Zierler RE, Huang TW, Pulliam CW, Radke HM
Am J Surg 1988 Nov;156(5):346-52. doi: 10.1016/s0002-9610(88)80183-1. PMID: 3189704

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
Recurrent risk of ischemic stroke due to Vertebrobasilar Dolichoectasia.
Chen Z, Zhang S, Dai Z, Cheng X, Wu M, Dai Q, Liu X, Xu G
BMC Neurol 2019 Jul 17;19(1):163. doi: 10.1186/s12883-019-1400-9. PMID: 31315603Free PMC Article
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

Recent systematic reviews

Natural History of Vertebrobasilar Dolichoectatic and Fusiform Aneurysms: A Systematic Review and Meta-Analysis.
Nasr DM, Flemming KD, Lanzino G, Cloft HJ, Kallmes DF, Murad MH, Brinjikji W
Cerebrovasc Dis 2018;45(1-2):68-77. Epub 2018 Feb 13 doi: 10.1159/000486866. PMID: 29439265
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

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