Hypoplasia of the right vertebral artery: clinical aspects and methods of treatment

Under the title "Hypoplasia of the right vertebral artery" in practical medicine is meant a specific pathological condition that is characterized by the development of the vessel, which as a result affects hemodynamics in the brain, especially in the posterior parts of it, where the Wilysian circle is formed from the vessels of its basin. Normally, a person has developed two vertebral arteries that branch off from the subclavian artery and are sent to the skull in a specific way. The peculiarity of the arrangement of vessels in the cervical region is that they pass in a special interrupted channel, which is formed due to the presence of vertebral openings in the transverse processes of the cervical vertebrae C7-C2. At the level of the second cervical vertebra, the artery forms a siphon (physiological bend) to reduce the pulse wave and pulse of arterial pressure before entering the cranial cavity. In this case, hypoplasia of the vertebral artery is most often observed on the site from the branch site from the larger vessel to the moment of bending.

The essence of the concept of "hypoplasia of the right vertebral artery" and the pathogenesis of the process

Under hypoplasia is meant the underdevelopment of the vessel, which is characterized by a significant narrowing of its lumen in the place of passage in the bone channel. This narrowing, associated with a violation of the development of the neck and spine, leads to a slow increase in symptoms. It is seldom possible to recognize it at the primary unspecialized examination, as the patient's complaints about soreness in the cervical section are more pronounced. However, hypoplasia of the right vertebral artery is not connected in any way with the cervical pain syndrome, since at this level it does not give off branches, which means that the neck organs can not experience ischemia due to its narrowing. Therefore, the main pathology undergoes correction, after which the symptoms of dizziness pass independently.

In fact, for the diagnosis to be guided by the principles of pathological relevance, since with deformities of the cervical vertebrae, the disease has the opportunity to develop in a one-sided and two-sided variants. Such a process is stretched in time and proceeds much more favorably due to compensatory intensification of blood flow through intact vessels with an increase in their lumen. Pathology is given little importance and due to a special device of the circulatory system of the brain, which is entirely built on extensive anastomosing of the arteries. In this case, only the posterior parts, the brain stem and the cerebellum can suffer with bilateral hypoplasia of the vertebral artery.

Compensation of hypoplasia with physiological capabilities of the body

If there is an isolated hypoplasia of the right vertebral artery, then the symptomatology includes a number of non-specific signs that result from functional disorders of the blood supply to the posterior parts of the brain. In fact, if it manifests, the process is clearly decompensated and requires surgical treatment. However, until this moment, while the brain does not experience a circulatory deficit, for treatment such as hypoplasia of the right vertebral artery, treatment should include only pharmacological agents that dilate the blood vessels of the arterial bed.

Hypoplasia of the right vertebral artery: diagnosis

Recognition of the disease is carried out at a primary examination with a neurologist. They take into account complaints about discoordination, rare fainting, staggering when getting up. Assessing them, as well as the likelihood of violations in the structure of the cervical spine, a neurologist has the right to send a patient to an ultrasound examination of the vertebral arteries. At the same time, the narrowing of the lumen up to 2 mm in diameter (in norm 3,6 - 3,8 mm) is a clear diagnostic sign, morphologically confirming the presence of the disease. Angiography can also be performed with the introduction of contrast.