How is vertebral artery tortuosity formed?
Vertebral artery tortuosity is a congenital vascular dysplasia, and many patients experience it due to cervical spondylosis. Cervical spondylosis can lead to narrowing and elongation of the vertebral artery, resulting in insufficient blood supply to the brain and symptoms such as dizziness and headache. Therefore, patients with vertebral artery tortuosity should undergo vasodilation to improve blood circulation.
Vertebral artery tortuosity may be related to congenital vascular dysplasia, as well as acquired causes such as atherosclerosis, vasospasm, and cervical spondylosis. The most common disease associated with it is vertebral artery type cervical spondylosis, which is mainly caused by various factors leading to narrowing of the vertebral artery itself, external stimulation and compression of the vertebral artery, or relative elongation and tortuosity of the vertebral artery, resulting in insufficient blood supply to the vertebral artery and manifesting as symptoms such as dizziness, headache, and syncope.
The main branches of the vertebral artery after entering the intracranial cavity are the posterior inferior cerebellar artery and the anterior spinal artery, and then the bilateral vertebral arteries synthesize into the basilar artery. Therefore, the clinical manifestations are mainly ischemia symptoms of the brain stem, cerebellum, and cervical spinal cord, such as posterior inferior cerebellar artery syndrome and brainstem lesion signs, manifesting as vertigo, ataxia, dysphagia, facial numbness, paralysis of the oculomotor nerve and tongue, etc. Basilar artery embolism can cause eye movement disorders, facial paralysis, hemiplegia, quadriplegia, and coma. Anterior spinal artery embolism syndrome is mainly manifested as quadriplegia, with upper limbs being more severe than lower limbs, accompanied by mild sensory disturbances. The recovery process of quadriplegia is first the lower limbs and then the upper limbs, and the recovery of hand function is often slower.
Vertebral artery tortuosity can cause insufficient blood supply to the vertebrobasilar artery, leading to dizziness attacks. On the one hand, symptomatic vasodilatation and improvement of circulation drugs are used for treatment. On the other hand, the underlying causes are identified and treated accordingly, such as treating cervical spondylosis and atherosclerosis. Vascular stents can be placed for the treatment of more than 70% vascular stenosis. Buflomedil is a vasodilator drug specifically used for vasospasm, while propyl gallate has the effect of improving circulation and reducing blood viscosity, specifically for atherosclerosis and high blood viscosity. Therefore, the therapeutic goals of these two drugs are different, and they should be used according to the specific condition of the patient.
