The vertebrobasilar system is also called the back (posterior) circulation of the brain. This part of the brain contains structures that are crucial for keeping a person alive. For instance, the brainstem controls breathing and swallowing, among other things. Parts of the brain help with vision (occipital lobes) and movement coordination (cerebellum) are also located in the back of the brain.
Three main blood vessels provide blood flow to the back of the brain:
One basilar artery
Two vertebral arteries
Many different conditions may cause blood flow in the back part of the brain to be reduced or stopped. The most common cause is a stroke due to hardening of the arteries (atherosclerosis).
Vertebrobasilar vascular disorders may also be caused by a tear (dissection) in an artery wall. Dissection can be caused by clogged arteries or injuries such as a car accident. However, most of the time, no apparent cause of dissection can be identified.
Other less common causes of vertebrobasilar vascular disorders include connective tissue diseases and vasculitis.
Symptoms of strokes due to vertebrobasilar disorders may include:
Diet changes and medication to lower cholesterol and control blood pressure
Blood-thinning medications to lower your risk of stroke, such as aspirin, warfarin (Coumadin) or clopidogrel (Plavix)
There is no good surgical treatment for patients who have narrowing of the vertebrobasilar arteries.
The outlook depends in part on the underlying cause. Strokes are potentially life threatening, and require urgent medical care. Age and the person's overall health are taken into consideration when determining one's outlook for recovery. A substantial recovery can be expected in younger patients who have no significant medical problems.
Recovery also depends on the area of the brain that has been affected. The outlook is very poor when the patient is in a coma or cannot move both arms and legs.
Complications of vertebrobasilar circulatory disorders are stroke and its complications. The complications of stroke include:
Respiratory (breathing) failure (which may require use of a machine to help the patient breathe)
Lung problems (especially lung infections)
Dehydration and swallowing problems (sometimes leading to the placement of tubes in the stomach for artificial feeding)
Problems with movement or sensation, including paralysis and numbness
Formation of clots in the legs
Patients may have vision loss in one eye.
Complications caused by medications or surgery may also occur.
Calling your health care provider
Call 911 or your local emergency number, or get to the emergency room if you have any symptoms that may suggest a vertebrobasilar circulatory disorder.
You can reduce your risk of stroke due to atherosclerosis by:
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Adams RJ, Albers G, Alberts MJ, Benavente O, Furie K, Goldstein LB, et al. Update to the AHA/ASA recommendations for the prevention of stroke in patients with stroke and transient ischemic attack. Stroke. 2008 May;39(5):1647-52. Epub 2008 Mar 5.
Biller J, Love BB, Schneck MJ. Vascular Diseases of the Nervous System. In: Bradley WG, Daroff RB, Fenichel GM, Jankovic J, eds. Neurology in Clinical Practice. 5th ed. Philadelphia, Pa: Butterworth-Heinemann; 2008:chap 55.
Daniel Kantor, MD, Medical Director of Neurologique, Ponte Vedra, FL and President of the Florida Society of Neurology (FSN). Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.