What Is Vertebrobasilar Insufficiency?

Medically Reviewed by Murtaza Cassoobhoy, MD on March 19, 2023
Written by WebMD Editorial Contributors
4 min read

Vertebrobasilar disease affects your body’s arterial system. The disease involves many conditions that impact blood flow to the back of your brain using the vertebral and basilar arteries. This disease is also called vertebrobasilar insufficiency because of the lack of blood flow.

Blood flow delivers oxygen to your brain, keeping the structures healthy for communicating with the rest of your body. Vertebrobasilar insufficiency‌ specifically affects blood flow to the parts of your brain that provide movement and balance. These areas of the brain receive blood from the carotid arteries on each side of your neck and vertebral arteries that join at the base of your neck to form your basilar artery.

When your arteries harden over time, it's called atherosclerosis. Professionals believe this is the primary cause of vertebrobasilar insufficiency. When your arteries narrow from hardening, your blood doesn’t flow as freely to those posterior parts of the brain.‌

If you have vertebrobasilar disease, you’re at risk for stroke or transient ischemic attack (TIA), which is a mini-stroke. TIA creates symptoms similar to that of a stroke, but they usually resolve within 24 hours. Strokes that occur in this portion of the brain are particularly devastating. If you have a true stroke, you may sustain lifelong damage. In some cases, a stroke may result in death.‌

Vertebrobasilar insufficiency is twice as likely to happen to a man than a woman. As you get older, you're also more likely to experience the disease. Your risk increases at younger ages if you have plaque buildup, also called atherosclerotic disease, in your arteries. These risk factors may include:

  • Diabetes
  • High cholesterol
  • Hypertension
  • Obesity
  • Sedentary lifestyl‌e
  • Smoking

Because blood flow to your brain can affect a wide variety of functions, symptoms vary. They depend on the severity of blood flow restriction as well as the areas of the brain that are affected.

Vertebrobasilar may also be called vertebrobasilar insufficiency (VBI) if it has a whole-brain effect or vertebral basilar ischemia if there is restricted blood flow to a particular organ. Symptoms to watch for may include:

  • Vertigo, feeling suddenly dizzy with no explanation
  • Vision changes including blurry, graying, cloudy, or double vision
  • Falling without cause
  • Feeling numbness or tingling
  • Slurring your speech or losing words
  • Feeling confused‌
  • Difficulty swallowing

If you have concerns about your symptoms, talk to your doctor right away. After completing a physical exam and talking to you about family medical history, your doctor may complete the following tests:

  • CT scan or MRI of your brain
  • Computed tomography angiography (CTA), magnetic resonance angiography (MRA), or an ultrasound to get a closer look at your blood vessels
  • Blood tests that may include a study on your blood’s clotting factor
  • Echocardiogram
  • Electrocardiogram (ECG)
  • Holter monitor, which is a 24-hour ECG for constant monitoring‌
  • Angiogram, or X-rays of your arteries

While medication and surgery are options to treat vertebrobasilar insufficiency, your doctor may first ask that you take steps toward a healthier lifestyle. This may include:

  • Stopping smoking
  • Cutting back on alcohol
  • Exercising more
  • Following a low-cholesterol diet‌
  • Carefully controlling your diabetes

You may need medications to:

  • Lower your blood pressure
  • Lower your cholesterol
  • Prevent a stroke like aspirin, another antiplatelet drug, or a blood thinner

If these changes and medications don’t improve your blood flow enough, your doctor may suggest surgery. Your options may include:

  • Endarterectomy – removing plaque from the affected arteries
  • Bypass grafting – taking a blood vessel from another part of your body to replace the damaged one
  • Vertebral artery reconstruction – repairing damage caused by the disease
  • Angioplasty – a small balloon is inserted into your artery to open it up more‌
  • Stenting – A wire-mesh tube is placed in your artery to help it maintain a wider position for better blood flow

The quality of your life with vertebrobasilar insufficiency depends on how quickly the disease is identified and treated. If the disease goes on too long, you may be left with permanent brain damage, limited body function, and the need for long-term care.‌

If you catch it early and make the necessary lifestyle changes to improve your arterial function, blood flow to your brain can be restored. This lessens your risks of permanent damage and also alleviates symptoms you are experiencing.‌

Complications of the disease may include:

  • Respiratory failure – if you have difficulty breathing on your own, you may need an oxygen machine to assist
  • Lung problems – persistent infections are especially common
  • Heart attack
  • Dehydration – you may not have enough fluids in your body
  • Problems swallowing – this may lead to a need for tube feeding
  • Difficulty moving or feeling sensations, which may include paralysis and numbness
  • Blood clots forming in your legs
  • Losing your vision

Medications and surgery also pose risks of their own. Talk to your doctor about the pros and cons of your choices so you can make the best decisions for your health.