VBI/ CAD

Question 1

What is it

Answer 1

Vertebrae insufficiency (VBI) - reduced blood flow to the vertebrae arteries which supply the brainstem, cerebellum & posterior part of the brain.

Cervical artery dissection (CAD) - is a tear in the vertebral or carotid artery, leading to blood clot formation and reduced blood flow.

Question 2

Features

Answer 2

Dizziness
Visual disturbances
Nausea and vomiting
Balance problems
Headaches
Neck pain
Slurred speech
Numbness
Weakness in limbs

Question 3

Epidemiology

Answer 3

VBI - common in older adults - more so with atherosclerosis

VBI - men - higher cardiovascular disease

CAD - rare, leading causes of strokes in young adults

CAD - Men & woman

Question 4

AGE

Answer 4

VBI - 50+
CAD - commonly 30 - 50

Question 5

Risk for VBI

Answer 5

Atherosclerosis,
hypertension,
diabetes,
smoking,
hyperlipidemia,
history of strokes

Question 6

Risk of CAD

Answer 6

Trauma
Hypertension,
Recent infections (weakening the artery walls
Family history

Question 7

Presentation - VBI

Answer 7

5Ds, 3Ns, and A

Question 8

Presentation for CAD

Answer 8

Neck pain - severe, sharp or throbbing pain
Horner’s syndrome - ptosis (drooping eyelid), miosis (pupil constriction)
Stroke like symptoms
Headaches - unilateral, intense and sudden

Question 9

Prognosis

Answer 9

VBI - treatable if identified early, addressing risk factors such as hypertension
VBI - without Managment risk of stroke increases

CAD - major cause of strokes
CAD - potential long term complications with neurological deficits