Extracranial and Transcranial Ultrasound Assessment in Patients with Suspected Positional ‘Vertebrobasilar Ischaemia’

Abstract

A diagnosis of 'positional' vertebrobasilar ischaemia should be made with extreme caution and only after a specialist assessment in a Balance Centre.

Carotid artery blood flow changes associated with head positioning in patients undergoing thyroidectomy

“…Limitations of the study include the restriction of the field of study to the flow changes within both common carotid arteries realizing the fact that the analysis is not complete with cerebral oxygenation. The usage of transcranial Doppler measurements[ 10 11 ] of both anterior and posterior cerebral circulation gives a better assessment of cerebral blood flow. Furthermore, the postoperative cognitive functions of the patients were not assessed.…”

The low-dose combination preparation Vertigoheel activates cyclic nucleotide pathways and stimulates vasorelaxation

“…While perfusion deficits in the large cerebral blood vessels, e.g. in cardiac disease [31], subclavian steal syndrome [36], or positional vertebrobasilar ischaemia [44], have been recognized for long as potential causes of dizziness and vertigo, recent hypotheses focus on the role of transient or chronic impairments of microvascular perfusion and homeostasis in inner ear syndromes such as peripheral vertigo and dizziness of unknown origin [35,40]. This notion is in line with clinical experiences that have by and large demonstrated the effectiveness of pharmacological approaches with histamine analogs [5] or phytotherapeutic interventions with Ginkgo biloba [47] or Vertigoheel [16] for the treatment of dizziness and vertigo.…”

Effects of Head and Neck Positions on Blood Flow in the Vertebral, Internal Carotid, and Intracranial Arteries: A Systematic Review

“…The majority (n = 26) 1,2,4,6,7,12,18,19,[27][28][29][30]32,33,35,36,38,40,41,43,44,[47][48][49][50]57 of the 31 included studies used a color duplex sonography device to measure flow velocities and flow volumes. The remaining 5 studies used magnetic resonance angiography (n = 3) 17,52,53 and magnetic resonance imaging (n = 2).…”

“…1,2,4,6,12,17,[28][29][30][39][40][41]44,50,52,53,55 Other test positions included sitting (n = 7) 7,18,19,32,36,49,57 and prone (n = 1), 33 or were not mentioned (n = 6). 27,35,38,43,47,48 For the vertebral artery, maximum rotation (n = 18) 2,17,18,29,30,32,33,36,[39][40][41]43,49,50,52,53,55,57 and the combination of maximum rotation and maximum extension (n = 6) 2,6,29,40,49,50 were the cervical positions te...…”

“…Vascular test maneuvers as described by Wallenberg or de Kleyn, which are all combinations of maximum rotation and maximum extension, were included in the latter position. 6 Other cervical positions in which the vertebral artery was tested were maximum rotation and distraction; maximum rotation at C1-C2 53 ; rotation at 5° to 15°5 0 ; rotation at 30°3 6 ; rotation at 45°1 8,29,39,57 ; rotation at 60°3 5 ; maximum extension 2,27,41,50,55 ; maximum extension and 45° of rotation 1 ; maximum extension, maximum rotation, and distraction 29 ; premanipulative positions at C1-C2 2,4,12 ; maximum flexion and maximum rotation 49 ; distraction 7 ; and a posttest in neutral. 57 For the carotid artery, maximum rotation (n = 4) 40,52,53,55 was also most frequently tested, followed by maximum extension and maximum rotation (n = 2).…”