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Vertebrobasilar Insufficiency

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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.

Also Known As:

Basilar Artery Ischemia; Basilar Insufficiency; Vertebral Artery Ischemia; Vertebro-Basilar Insufficiency; Vertebro-Basilar Ischemia; Vertebrobasilar Dolichoectasia; Vertebrobasilar Ischemia; Artery Insufficiencies, Basilar; Artery Insufficiencies, Vertebral; Artery Insufficiency, Basilar; Artery Insufficiency, Vertebral; Artery Ischemia, Basilar; Artery Ischemia, Vertebral; Artery Ischemias, Basilar; Artery Ischemias, Vertebral; Artery Stenoses, Basilar; Artery Stenoses, Vertebral; Artery Stenosis, Basilar; Artery Stenosis, Vertebral; Basilar Artery Insufficiencies; Basilar Artery Ischemias; Basilar Artery Stenoses; Basilar Insufficiencies; Dolichoectasia, Vertebrobasilar; Dolichoectasias, Vertebrobasilar; Insufficiencies, Basilar; Insufficiencies, Basilar Artery; Insufficiencies, Vertebral Artery; Insufficiencies, Vertebro-Basilar; Insufficiencies, Vertebrobasilar; Insufficiency, Basilar; Insufficiency, Basilar Artery; Insufficiency, Vertebral Artery; Insufficiency, Vertebro-Basilar; Insufficiency, Vertebrobasilar; Ischemia, Basilar Artery; Ischemia, Vertebral Artery; Ischemia, Vertebro-Basilar; Ischemia, Vertebrobasilar; Ischemias, Basilar Artery; Ischemias, Vertebral Artery; Ischemias, Vertebro-Basilar; Ischemias, Vertebrobasilar; Stenoses, Basilar Artery; Stenoses, Vertebral Artery; Stenosis, Basilar Artery; Stenosis, Vertebral Artery; Vertebral Artery Insufficiencies; Vertebral Artery Ischemias; Vertebral Artery Stenoses; Vertebro Basilar Insufficiency; Vertebro Basilar Ischemia; Vertebro-Basilar Insufficiencies; Vertebro-Basilar Ischemias; Vertebrobasilar Dolichoectasias; Vertebrobasilar Insufficiencies; Vertebrobasilar Ischemias; Basilar Artery Insufficiency; Basilar Artery Stenosis; Vertebral Artery Insufficiency; Vertebral Artery Stenosis

Networked: 229 relevant articles (16 outcomes, 20 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Brain Ischemia (Cerebral Ischemia)
2.	Pathologic Constriction (Stenosis)
3.	Unstable Angina
4.	Intracranial Vasospasm
5.	Multi-Infarct Dementia (Dementia, Multi Infarct)

Experts

1.	Costa, Marco A: 2 articles (06/2015 - 01/2014)
2.	Attizzani, Guilherme Ferragut: 2 articles (06/2015 - 01/2014)
3.	Bezerra, Hiram G: 2 articles (06/2015 - 01/2014)
4.	Brooks, William H: 2 articles (06/2015 - 01/2014)
5.	Given, Curtis Alden: 2 articles (06/2015 - 01/2014)
6.	Jones, Michael R: 2 articles (06/2015 - 01/2014)
7.	Ramsey, Christian Norman: 2 articles (06/2015 - 01/2014)
8.	Spetzler, Robert F: 2 articles (03/2015 - 01/2015)
9.	Nakaji, Peter: 2 articles (01/2015 - 01/2014)
10.	Lu, Jun: 2 articles (12/2014 - 02/2007)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Vertebrobasilar Insufficiency:

1.	Piracetam (Nootropil)IBA 11/23/1985 - "A pilot study with piracetam (Nootropil; UCB) was performed in 5 selected dizzy patients who had a diagnosis of presbyvertigo or vertebrobasilar insufficiency. " 03/01/1999 - "This review of double-blind trials shows that piracetam alleviates vertigo after head injury, vertigo of central origin as, for example, in vertebrobasilar insufficiency and in peripheral vestibular disorders, especially in middle-aged and elderly subjects. " 01/01/1999 - "It has been described that the association of Dihydroergocristine-Piracetam (D-P) is a useful treatment for vertebro-basilar insufficiency. "
2.	CalciumIBA 01/01/1988 - "Calcium antagonists in an animal model of vertebrobasilar insufficiency." 01/01/1986 - "Calcium entry blockers in the treatment of vertebrobasilar insufficiency." 07/26/1984 - "[Calcium blockers in the therapy of vertebrobasilar insufficiency. " 01/01/1988 - "In order to study the efficacy of calcium antagonists in vertebrobasilar insufficiency, an animal model of VBI was developed by occluding one vertebral artery with a balloon catheter. "
3.	Dihydroergocristine FDA LinkGeneric 01/01/1999 - "It has been described that the association of Dihydroergocristine-Piracetam (D-P) is a useful treatment for vertebro-basilar insufficiency. " 07/01/1984 - "By recording and evaluating these parameters and data patterns, coupled with clinical findings, differential conclusions on reactions of the cerebral hemodynamics in macrocirculatory and microcirculatory regions were realized in geriatric patients under the following pathophysiological and therapeutically induced conditions: Generally and regionally accentuated arteriosclerotic lesions of the brain (predominant vertebrobasilar insufficiency), decrease of flow velocities according to the diameter, aggravation by distress; principal possibility of pharmacological influence if myogenic autoregulation function is rehabilitable: It is demonstrated by the example of a long-term therapy with a combination of Raubasine, Dihydroergocristine and DHE (Defluina forte)."
4.	Aspirin (Acetylsalicylic Acid)FDA LinkGeneric 02/01/1994 - "It is recommended for those who cannot take aspirin and may be more effective in certain groups--nonwhites, diabetics, and women and those with vertebrobasilar ischemia, intermittent claudication, unstable angina, and nonproliferative retinopathy." 07/01/2014 - "LMWH appears to have advantages over aspirin in certain subgroups, such as elderly patients and patients with posterior circulation and basilar artery stenosis."
5.	Alprostadil (Muse)FDA LinkGeneric 05/01/2014 - "Using an animal model of vertebrobasilar insufficiency (VBI), in which brainstem circulatory disturbance was induced in rats, we examined how prostaglandin E1 (PG-E1) affects brainstem blood flow (BBF) to clarify whether it is effective against VBI. " 05/01/2014 - "The effect of prostaglandin E1 on brainstem blood flow disturbance in an animal model of vertebrobasilar insufficiency."
6.	cytoflavinIBA 04/01/2010 - "[Efficacy of cytoflavin in the treatment of vertebrobasilar insufficiency]."
7.	glucuronyl glucosamine glycan sulfate (Vessel)IBA 07/01/2008 - "Cardiovascular and cerebrovascular pathology involving structural lesions of the heart and carotid or vertebral artery stenosis stemming from intima media thickening or vessel plaque formation can insidiously reduce blood flow to the brain. " 12/01/1999 - "Vertebrobasilar ischemia has been attributed to a reduction of net vertebral artery flow volume, the product of mean flow velocity and the cross-sectional area of the vessel. " 11/01/1994 - "Contrary to a common view, cardioembolism was not a more common etiology than basilar artery stenosis or small-vessel disease." 01/01/1987 - "Consequently, a vertebral artery stenosis narrowing the vessel diameter to less than 1/3 is without prognostic relevance." 06/24/1983 - "[Vertebrobasilar insufficiency correlated with arterial vessel changes]."
8.	ChloraloseIBA 01/01/1998 - "vertebrobasilar insufficiency; VBI), an electrophysiological study was performed to examine the effects of a unilateral vertebral artery (VA) occlusion on the neuronal activities of the medial vestibular nucleus (MVN) and vestibular ganglion (VG) in alpha-chloralose-anesthetized cats. " 08/01/2004 - "To elucidate the effectiveness of the drug in the treatment of vertebrobasilar insufficiency (VBI), we performed an electrophysiological study to examine the effects of ipenoxazone hydrochloride, a glutamate blocker, on hypoxia-induced firing in the medial vestibular nucleus (MVN) neuron, using alpha-chloralose-anesthetized cats. "
9.	XenonIBA 09/01/1990 - "Vertebrobasilar insufficiency: stable xenon computed tomography-cerebral blood flow study in posterior circulation revascularization." 09/01/1991 - "We propose to define nuclear hemodynamic vertebrobasilar insufficiency on the basis of an oligemia lower than 35 mL/100 g per minute in the brain stem-cerebellar region with use of the xenon Xe 133 inhalation method. " 09/01/1990 - "Preoperative and postoperative local cerebral blood flow were measured by the stable xenon computed tomography-cerebral blood flow technique in 15 patients with vertebrobasilar insufficiency. "
10.	Betahistine (Serc)IBA 01/01/2004 - "The aim of this study was to observe the usefulness of betahistine dihydrochloride--Betaserc--in therapy for vestibular disorders in patients with vertebrobasilar insufficiency. " 01/01/2004 - "The usefulness of Betaserc in vertebrobasilar insufficiency was proved, 4-6 months' therapy was sufficient, and the effect on central compensation seemed to be most probable." 01/01/2004 - "Betahistine in vertebrobasilar insufficiency." 01/01/2008 - "In conclusion, the fixed combination proved to be statistically more effective than the common antivertiginous drug betahistine in reducing vertebrobasilar insufficiency-associated vertigo symptoms."

Therapies and Procedures

1.	Angioplasty (Angioplasty, Transluminal) 03/01/2009 - "Basilar artery angioplasty with or without stenting is an emerging and promising treatment for vertebrobasilar insufficiency that is refractory to medical therapy. " 01/01/2005 - "The objective of this review was to assess the safety and efficacy of vertebral artery percutaneous transluminal angioplasty, with or without stenting, combined with medical care, compared to medical care alone, in patients with vertebral artery stenosis. " 04/01/2012 - "A systematic review of the literature identified all studies reporting percutaneous transluminal angioplasty or stenting, or both, for proximal vertebral artery stenosis. " 05/01/2007 - "Long-term outcome after angioplasty and stenting for symptomatic vertebral artery stenosis compared with medical treatment in the Carotid And Vertebral Artery Transluminal Angioplasty Study (CAVATAS): a randomized trial." 01/01/2000 - "Randomised trials of vertebral percutaneous transluminal angioplasty (with or without stenting) combined with best medical therapy, compared with best medical therapy alone, in people with symptomatic vertebral artery stenosis. "
2.	Stents 01/01/2016 - "The aim of this study was to evaluate the efficacy of stenting for patients with intra-cranial vertebral artery stenosis by trans-cranial color-coded sonography and to analyze the risk factors of in-stent restenosis (ISR). " 01/01/2016 - "In total, 121 patients with intra-cranial vertebral artery stenosis stents were included. " 12/01/2014 - "Endovascular stenting with a balloon expandable device is currently the preferred treatment modality for symptomatic proximal vertebral artery stenosis, but high rates of in-stent restenosis remain a major problem, for which stent fracture might be a contributing factor. " 04/01/2014 - "Numerical simulation of vertebral artery stenosis treated with different stents." 04/01/2012 - "Drug-eluting vs. bare metal stents for symptomatic vertebral artery stenosis."
3.	Catheters 02/09/2010 - "The aim of this study was to demonstrate the safety and long-term durability of catheter-based therapy for symptomatic vertebral artery stenosis (VAS). " 10/01/1995 - "Autoperfusion balloon catheter for treatment of vertebral artery stenosis." 12/01/2009 - "Following uneventful balloon angioplasty, a symptomatic intracranial vertebral artery stenosis was inaccessible to Wingspan stent delivery using standard procedural protocol because of poor proximal guide catheter purchase. " 01/01/1988 - "In order to study the efficacy of calcium antagonists in vertebrobasilar insufficiency, an animal model of VBI was developed by occluding one vertebral artery with a balloon catheter. "
4.	Carotid Endarterectomy 07/01/1984 - "There was a greater likelihood of severe vertebral artery stenosis in those patients whose symptoms were not relieved by carotid endarterectomy." 10/01/1994 - "[A case of emergency carotid endarterectomy to cope with vertebrobasilar insufficiency]." 01/01/1988 - "[Carotid endarterectomy in vertebrobasilar insufficiency syndromes. " 01/01/1986 - "[Carotid endarterectomy in vertebrobasilar insufficiency]." 07/01/1984 - "Posterior communicating artery visualization in predicting results of carotid endarterectomy for vertebrobasilar insufficiency."
5.	Musculoskeletal Manipulations (Manipulative Therapy) 10/01/1991 - "Treating the patients with drugs in combination with manual therapy resulted in improved circulation in the vertebral artery bed, lower clinical signs of vertebrobasilar insufficiency. " 03/01/2002 - "This case also demonstrated that spinal manipulative therapy may be safely used on patients with vertebrobasilar insufficiency when the biomechanics and related flow studies are elucidated." 01/01/2007 - "Manual therapy healthcare practitioners routinely perform the vertebral artery test (VAT) to determine cervical positional tolerance and to screen for vertebrobasilar insufficiency (VBI) prior to manipulating the cervical spine. " 07/01/2005 - "In view of manipulative therapy and in the detection of vertebrobasilar insufficiency, one has to bear in mind that cases of non-union may influence the interpretation of these tests." 05/01/2005 - "Growing evidence supports the effectiveness of manual therapy interventions in patients with neck pain; however, considerable attention has also been afforded to the potential risks such as vertebrobasilar insufficiency (VBI). "