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390:. Patients are often started on an antiplatelet (e.g. aspirin, clopidogrel) or occasionally an anticoagulant (e.g. warfarin) to reduce the risk of future strokes. Where VBI is causing reproducible symptoms due to stenosis, lifestyle modification to avoid provoking factors (e.g. dehydration, standing rapidly from sitting or lying) may reduce symptoms.
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The diagnosis of posterior circulation stroke or TIA can be made on the basis of history and physical examination, which should include exclusion of alternative causes for the patient's symptoms and consideration of risk factors for atherosclerosis. To confirm VBI, imaging studies of the posterior
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VBI should not be confused with other conditions which may relate to the posterior circulation. 25% of strokes and TIAs affect parts of the brain supplied by the posterior circulation, but many of these are
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can be performed to re-open stenosed vertebral arteries, and intracranial stents have also been successfully used. Further research is required to determine which patients with VBI are likely to benefit.
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Where stenosis is severe, abrupt changes in blood pressure can temporarily result in inadequate flow through the stenosis, causing symptoms that are usually very brief. A common cause is
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278:, however other pathologies such as fibromuscular dysplasia, dissection, trauma or external compression may occur. Atherosclerotic plaque can rupture, resulting in a source of
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is a relatively common symptom that can result from ischemia to the cerebellum, medulla or (rarely) the internal auditory artery which supplies the vestibular system of the
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311:(sometimes referred to as Bow Hunter's Syndrome) results from vertebral artery compression on rotating the neck. The commonest cause is a bone spur from a cervical
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262:. While vertigo is a common feature of VBI or posterior circulation stroke, VBI only rarely presents with vertigo alone (without other neurological signs).
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The term 'vertebrobasilar insufficiency' may be used to describe disease in the vertebral and basilar arteries which predisposes to acute
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Atherosclerosis is a common finding, and its presence does not confirm that this was the cause of the patient's symptoms.
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508:"Stroke among patients with dizziness, vertigo, and imbalance in the emergency department: A population-based study"
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Symptoms relate to impaired brain function in areas supplied by the posterior circulation, as seen in
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445:"Vertebrobasilar Atherothrombotic Disease: Practice Essentials, Background, Pathophysiology"
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The main treatment for VBI is to address risk factors for atherosclerosis such as smoking,
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is often the first study performed in acute stroke or TIA, as it is effective at excluding
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605:"CT angiography of the cerebral arteries (protocol) | Radiology Reference Article"
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Kerber, K. A.; Brown, D. L.; Lisabeth, L. D.; Smith, M. A.; Morgenstern, L. B. (2006).
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brought on by extreme head positions, such as those maintained during hair washing.
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VBI is described as a cause of symptoms that occur with changes to head position.
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Brief episodes of vertigo brought on by head movements are more likely to be
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and (in 70-80% of people) supplies the posterior cerebellar artery to the
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is better at detecting ischemic strokes in the posterior distribution.
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VBI results from narrowing of posterior circulation arteries, known as
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631:"Angioplasty for symptomatic intracranial stenosis: clinical outcome"
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Spinal muscular atrophy with lower extremity predominance (SMALED)
417:"Posterior cerebral circulation | Radiology Reference Article"
252:. However, symptoms may be far briefer than those seen in stroke.
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VBI may also result from altered blood flow as seen in
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VBI is often considered when a patient complains of
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629:Marks MP, Wojak JC, Al-Ali F, et al. (2006).
274:. The most common cause of arterial stenosis is
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177:. The posterior circulation supplies the
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106:Learn how and when to remove this message
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1589:Distal hereditary motor neuronopathies
1262:Template:Demyelinating diseases of CNS
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7:
1982:Partial anterior circulation infarct
1440:Idiopathic intracranial hypertension
368:Benign paroxysmal positional vertigo
309:Rotational vertebral artery syndrome
44:adding citations to reliable sources
1977:Total anterior circulation infarct
1778:Posterior cerebral artery syndrome
1671:Infantile progressive bulbar palsy
648:10.1161/01.STR.0000206142.03677.c2
524:10.1161/01.STR.0000240329.48263.0d
471:"Warning over 'hair salon stroke'"
14:
1768:Anterior cerebral artery syndrome
1374:Template:Cerebrovascular diseases
1177:Frontotemporal lobar degeneration
2151:Cerebral venous sinus thrombosis
1394:For more detailed coverage, see
1372:For more detailed coverage, see
1343:For more detailed coverage, see
1309:For more detailed coverage, see
1260:For more detailed coverage, see
586:"What is Bow Hunter's Syndrome?"
20:
1929:Anterior spinal artery syndrome
1773:Middle cerebral artery syndrome
560:"Vertebrobasilar Insufficiency"
157:) describes a temporary set of
55:"Vertebrobasilar insufficiency"
31:needs additional citations for
372:carotid sinus hypersensitivity
342:Magnetic Resonance Angiography
324:circulation can be performed.
1:
1934:Vertebrobasilar insufficiency
1687:Amyotrophic lateral sclerosis
1572:Hereditary spastic paraplegia
1430:Normal pressure hydrocephalus
250:posterior circulation strokes
151:Vertebrobasilar insufficiency
124:Vertebrobasilar insufficiency
1656:Progressive muscular atrophy
1166:Primary progressive aphasia
558:Pirau, L.; Lui, F. (2019).
2193:
1903:Cerebellar stroke syndrome
1836:Lateral medullary syndrome
1488:Hashimoto's encephalopathy
1194:Posterior cortical atrophy
1015:Striatonigral degeneration
866:Cavernous sinus thrombosis
210:transient ischemic attacks
2128:Charcot–Bouchard aneurysm
1972:Transient ischemic attack
1939:Subclavian steal syndrome
1831:Medial medullary syndrome
1821:Brainstem stroke syndrome
1594:Spinal muscular atrophies
1562:Primary lateral sclerosis
1420:Intracranial hypertension
1200:Creutzfeldt–Jakob disease
302:subclavian steal syndrome
2010:Transient global amnesia
1857:Lateral pontine syndrome
1793:Dejerine–Roussy syndrome
1739:Cerebrovascular diseases
1661:Progressive bulbar palsy
1452:Intracranial hypotension
1435:Choroid plexus papilloma
849:Herpesviral encephalitis
393:Open surgical repair or
330:intracranial haemorrhage
2101:Intracranial hemorrhage
1919:Carotid artery stenosis
1848:Medial pontine syndrome
1173:Frontotemporal dementia
859:Encephalitis lethargica
287:orthostatic hypotension
234:beauty parlour syndrome
1478:Hepatic encephalopathy
2123:Intracranial aneurysm
1912:Extracranial arteries
1536:Ataxia–telangiectasia
1493:Static encephalopathy
1216:Mitochondrial disease
1054:Spasmodic torticollis
964:Basal ganglia disease
351:Alternative diagnoses
2059:Cerebral/Intra-axial
2005:Binswanger's disease
1483:Toxic encephalopathy
1189:Lewy bodies dementia
40:improve this article
2146:Cerebral vasculitis
2024:Haemorrhagic stroke
1962:Cerebral infarction
1531:Friedreich's ataxia
914:Meningoencephalitis
854:Limbic encephalitis
173:circulation of the
2085:Duret haemorrhages
1567:Pseudobulbar palsy
1305:Status epilepticus
1256:Multiple sclerosis
1093:Myoclonic epilepsy
956:movement disorders
902:Acute disseminated
844:Viral encephalitis
741:External resources
451:. 10 November 2021
370:. Alternatively,
244:Signs and symptoms
2172:Vascular diseases
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1883:Claude's syndrome
1878:Benedikt syndrome
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1345:Template:Headache
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1473:Reye syndrome
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1425:Hydrocephalus
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1238:Demyelinating
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1126:Restless legs
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1064:Blepharospasm
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1020:Hemiballismus
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871:Brain abscess
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57: –
56:
52:
51:Find sources:
45:
41:
35:
34:
29:This article
27:
23:
18:
17:
2049:Subarachnoid
1933:
1681:
1580:
1553:
1514:Degenerative
1251:Inflammatory
1198:
1131:Stiff-person
969:Parkinsonism
942:Degenerative
839:Encephalitis
822:Inflammation
812:, primarily
759:
748:
724:
713:
698:
683:
638:
634:
624:
612:. Retrieved
608:
598:
589:
580:
563:
515:
511:
501:
491:
479:. Retrieved
474:
465:
453:. Retrieved
448:
424:. Retrieved
420:
410:
392:
384:hypertension
381:
365:
361:light-headed
354:
346:
322:
308:
306:
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269:
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247:
233:
222:
203:
154:
150:
149:
102:
93:
83:
76:
69:
62:
50:
38:Please help
33:verification
30:
2032:Extra-axial
1924:precerebral
1666:Fazio–Londe
1506:Both/either
1300:Generalised
1159:Early-onset
1154:Alzheimer's
889:spinal cord
750:MedlinePlus
212:(TIAs) and
2166:Categories
1895:Cerebellum
1813:Brain stem
1741:including
1274:paroxysmal
1246:Autoimmune
1039:Dyskinesia
909:Meningitis
887:Brain and
726:DiseasesDB
564:StatPearls
402:References
332:, however
238:dissection
191:cerebellum
163:blood flow
66:newspapers
2077:Brainstem
1852:Foville's
1271:Episodic/
1149:Tauopathy
1100:Akathisia
1088:Myoclonus
1071:Athetosis
1003:Tauopathy
766:emerg/834
761:eMedicine
590:Webmd.com
449:EMedicine
378:Treatment
357:dizziness
319:Diagnosis
295:dizziness
266:Pathology
260:inner ear
171:posterior
169:) in the
135:Neurology
130:Specialty
96:June 2020
2115:Aneurysm
2044:Subdural
2039:Epidural
1868:Midbrain
1637:SMALED2B
1632:SMALED2A
1329:Migraine
1321:Headache
1287:epilepsy
1283:Seizures
1141:Dementia
1044:Dystonia
657:16497979
614:26 April
572:29489229
542:16946161
481:26 April
455:26 April
426:26 April
395:stenting
388:diabetes
313:vertebra
272:stenosis
218:stenosis
195:thalamus
187:midbrain
167:ischemia
159:symptoms
2094:General
2000:CADASIL
1826:Medulla
1649:SMA-PME
1644:SMA-PCH
1627:SMALED1
1339:Tension
1334:Cluster
1059:Meige's
876:Amoebic
720:D014715
533:1779945
256:Vertigo
230:cardiac
226:embolic
206:embolic
179:medulla
80:scholar
1743:stroke
1368:Stroke
1182:Pick's
1109:Tremor
1076:Chorea
755:001423
655:
635:Stroke
570:
540:
530:
512:Stroke
280:emboli
214:stroke
137:
82:
75:
68:
61:
53:
2139:Other
1993:Other
1760:Brain
1682:both:
1614:DSMA1
1609:SMAX2
1604:SMAX1
1584:only:
1557:only:
1461:Other
1383:Other
1295:Focal
928:Brain
831:Brain
731:29497
709:435.3
694:G45.0
228:from
175:brain
87:JSTOR
73:books
1843:Pons
1285:and
996:PKAN
991:NBIA
715:MeSH
704:9-CM
653:PMID
616:2022
568:PMID
538:PMID
483:2022
457:2022
428:2022
386:and
340:and
197:and
183:pons
59:news
1599:SMA
1582:LMN
1555:UMN
1546:MND
1412:CSF
1363:TIA
1008:PSP
984:NMS
953:and
814:CNS
700:ICD
685:ICD
643:doi
528:PMC
520:doi
334:MRI
155:VBI
42:by
2168::
1859:/
1850:/
1523:SA
1030:OA
1025:HD
974:PD
764::
753::
729::
718::
707::
692::
689:10
651:.
639:37
637:.
633:.
607:.
588:.
562:.
550:^
536:.
526:.
516:37
514:.
510:.
473:.
447:.
436:^
419:.
326:CT
304:.
189:,
185:,
181:,
1731:e
1724:t
1717:v
1175:/
930:/
801:e
794:t
787:v
702:-
687:-
677:D
659:.
645::
618:.
592:.
574:.
544:.
522::
485:.
459:.
430:.
165:(
153:(
109:)
103:(
98:)
94:(
84:·
77:·
70:·
63:·
36:.
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