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CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2017; 21(03): 302-307
DOI: 10.1055/s-0036-1593448
Systematic Review
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Pathophysiology and Diagnosis of Vertebrobasilar Insufficiency: A Review of the Literature

Arlindo Cardoso Lima Neto
1   Department of Otolaryngology, Banco de Olhos de Sorocaba Hospital, Sorocaba, São Paulo, Brazil
2   Department of Otoneurology, School of Medicine, Universidade de São Paulo (USP), São Paulo, Brazil
,
Roseli Bittar
2   Department of Otoneurology, School of Medicine, Universidade de São Paulo (USP), São Paulo, Brazil
,
Gabriel Scarabotolo Gattas
3   Department of Radiology, School of Medicine, USP, São Paulo, Brazil
,
Edson Bor-Seng-Shu
4   Department of Neurology, School of Medicine, USP, São Paulo, Brazil
,
Marcelo de Lima Oliveira
4   Department of Neurology, School of Medicine, USP, São Paulo, Brazil
,
Rafael da Costa Monsanto
1   Department of Otolaryngology, Banco de Olhos de Sorocaba Hospital, Sorocaba, São Paulo, Brazil
,
Luis Felipe Bittar
5   Department of Engineering, School of Engineering, USP, São Paulo, Brazil
› Author Affiliations
Further Information

Publication History

26 March 2016

23 August 2016

Publication Date:
26 October 2016 (online)

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Abstract

Introduction Vertebrobasilar insufficiency is defined as transitory ischemia of the vertebrobasilar circulation. Dizziness, vertigo, headaches, vomit, diplopia, blindness, ataxia, imbalance, and weakness in both sides of the body are the most common symptoms.

Objective To review the literature regarding the three available diagnostic testing in patients with dizziness complaints secondary to vertebrobasilar insufficiency (VBI): magnetic resonance angiography; transcranial Doppler ultrasound; and vertebrobasilar deprivation testing.

Data Synthesis We selected 28 studies that complied with our selection criteria for appraisal. The most frequent cause of the hemodynamic changes leading to VBI is atherosclerosis. The main clinical symptoms are dizziness, vertigo, headaches, vomit, diplopia, blindness, ataxia, imbalance, and weakness in both sides of the body. Even though arteriography is considered the most important exam to diagnose the disease, the inherent risks of this exam should be taken into consideration. The magnetic resonance angiography has been widely studied and is a good method to identify and localize any occlusions and stenosis in both neck and intracranial great vessels.

Conclusion Each patient with a suspected diagnosis of VBI should be individually evaluated and treated, taking in consideration the pros and cons of each diagnostic testing and treatment option.

Keywords

vertigo - ischemia - stroke - vertebrobasilar insufficiency - dizziness - pathophysiology
 

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