Vertebrobasilar insufficiency pathophysiology

Vertebrobasilar insufficiency
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Pathophysiology

The vertebral and basilar arteries supply the brain stem, cerebellum, and in most cases also the inferior temporal lobe, occipital lobe, and thethalamus. Variaties of reasons lead to impress the vertebral artery directly or indirectly may reduce the blood stream of posterior circulation of the brain; stimulation caused by the pathologic changes excite the sympathetic nerve and lead to the spasm of vertebral artery finally. Normally, the reduction of blood supply of unilateral veterbrobasilar artery doesn't arouse the ischemia of brain. However, beacuse of the pre-existing maldevelopment, stenosis, embolism or other reasons leads to the reduction of blood supply of contralateral veterbrobasilar artery, patient will suffer the symptoms of ischemia of conrresponding brain area. Sometimes, the reduction of unilateral vertebralbasilar is too serious that the compensation of blood from the unjuried side isn't enough to maintain the normal function of brain, the patient also suffer the symptoms. The sense organs of the visual, vestibular, and proprioceptive systems are connected with the cerebellum by way of the vestibular nuclei in the brainstem. Any disease that interrupts the integration of these 3 systems may give rise to symptoms of vertigo and disequilibrium.