The arteria vertebralis supplies the brain and parts of the spinal cord with oxygen-rich blood. Especially cerebellum, brain stem and occipital lobe are supplied by the arteria vertebralis (see anatomy). An important function of the arteria vertebralis only becomes relevant in the case of a specific clinical picture.
If a patient suffers from the so-called subclavian steal syndrome, it ensures the blood supply to the upper extremity by becoming part of a bypass circuit. In this clinical picture, the artery from which the vertebral artery originates, the subclavian artery, is constricted or completely blocked on one side. Since the arteria subclavia normally supplies the arm with blood, this is missing there.
In order to ensure the blood supply to the arm nevertheless, the arteria vertebralis is “tapped” on this side, which is why the syndrome is also called vertebralisanzapf syndrome. The blood flow in the vertebral artery is reversed and diverts blood from the opposite vertebral artery into the poorly supplied arm. However, since the blood is therefore not available to supply the brain, the brain may be undersupplied, especially when the arm is working harder, and patients develop symptoms such as dizziness or headaches.
Arteria vertebralis syndrome
The so-called arteria-vertebralis syndrome describes a circulatory disorder in this area. This can have various causes. On the one hand, the insufficient blood flow can be due to a hardening of the blood vessels (arteriosclerosis), which constricts the diameter of the artery and makes it harder for the blood to flow.
In this case one speaks of a vascular (vessel-related) arteria-vertebralis syndrome. On the other hand, the arteria vertebralis can also be constricted from the outside, for example by a tumour, an intervertebral disc of the cervical spine or the cervical vertebral body itself. This is then referred to as arteria vertebralis compression syndrome.
The symptoms of the arteria vertebralis syndrome are similar to those of the so-called basilaris migraine, as it mainly affects the areas of the brain that are supplied with blood by the basilar artery. The most important symptom is sudden dizziness caused by reduced blood flow to the inner ear. In the case of a compression syndrome, this is usually “vertebrogenic dizziness”.
Age-related changes in the cervical vertebrae can lead to the formation of so-called osteophytes, bony protrusions that protrude into the spaces between the individual vertebrae and can compress the arteria vertebralis. Rotational movements of the head can increase this narrowing of the artery. Since, among other things, the inner ear with the organ of equilibrium is also supplied by the arteria vertebralis, “vertebrogenic dizziness” can be triggered in this way.
In addition, many other unspecific symptoms such as headaches (especially at the back of the head), visual disturbances, ringing in the ears, nausea, vomiting, gait insecurity (ataxia) and sensitivity disorders can occur. About 50% of patients with vertebralis syndrome are also depressed. If the doctor has made the suspected diagnosis of arteria vertebralis syndrome by means of a neurological examination, an ultrasound and MRI examination is used to look for the cause.
This determines the therapy in the further course. If the arteria vertebralis is narrowed due to vascular calcification, it is often necessary to insert a so-called stent (plastic tube) into the vessel. This restores the blood flow and the symptoms disappear.
If the arteria vertebralis is constricted by a cervical vertebral body, conservative therapy without surgery is usually sufficient. The patient is prescribed painkillers as well as chiro- and physiotherapy. Surgery is indicated if the cause of the arteria vertebralis compression syndrome is a severe herniated disc (prolapse) of the cervical spine or if there is a compressive tumor in the cervical spine.