Vertebrobasilar syndrome

If a person often suffers from dizziness, he feels unsteady while walking, there is reason to suspect that he has a violation of blood flow in the vertebral arteries. And this means that the person is developing vertebrobasilar syndrome, the absence of treatment of which can cause a terrible disease - a stroke, the consequences of which are unpredictable.

The diagnosis may sound differently: vertebrobasilar insufficiency (VBI), vertebrobasilar syndrome, vertebrobasilar arterial system syndrome, vertebrobasilar insufficiency syndrome, but all these names denote one pathology, which should not be ignored. This pathology means that due to some reasons, there was a decrease in the blood supply to the body, coming from the vertebral (vertebral) and basilar (main) arteries, as a result of which there were failures in the functioning of the brain.

Epidemiology

Research shows that patients diagnosed with cervical osteochondrosis are particularly susceptible to VBN. A third of such patients find confirmed symptoms of vertebrobasilar syndrome. In addition, vertebrobasilar syndrome is the cause of almost a third of stroke cases.

As strange as it may sound, VBN affects people of different ages, including children from 3 years old. There are frequent cases of vertebrobasilar syndrome development at school age, when children are especially active, which can result in injuries during play activities or school activities (physical education lessons).

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Causes vertebrobasilar syndrome

A decrease in blood supply to the brain most often occurs due to a slowdown in blood flow in some part of the vertebrobasilar system. This gives grounds to assume the development of VBN. But for what reason can blood flow decrease?

There may be many such reasons, but some of them are quite common, while others have to be discussed as an exception. Here are the most common reasons for the development of vertebrobasilar syndrome:

• First place in popularity is, of course, cervical osteochondrosis, where VBN is observed in more than 30% of cases.
• A common cause of various vascular pathologies in adults and children is spinal injuries in the cervical region. This usually happens during sports activities or various types of accidents, as well as with improperly performed manual therapy.
• Vertebrobasilar syndrome can develop against the background of such a common disease as diabetes mellitus, when small arteries of the brain are at risk of damage.
• Arterial hypertension (consistently high blood pressure), which is especially common in adults, can easily provoke VBN and, consequently, a stroke.
• Atherosclerosis of blood vessels in itself indicates a decrease in vascular patency due to the deposition of cholesterol on the walls of blood arteries.
• Various inflammatory reactions affecting the walls of the arteries (arteritis) can also impede the flow of blood through the vessels.
• Blood clots formed inside a vessel can impede or even stop the flow of blood, especially in the case of thrombosis of the vertebral and basilar arteries. Increased thrombus formation is often found in young people.
• Damage to the arteries of the vertebrobasilar system, when their walls delaminate and blood leaks into the tissue.
• Cervical disc herniation, spondylosis and similar diseases can lead to compression of the vertebral and basilar arteries, as a result of which blood flow is disrupted.
• Congenital pathologies of the structure of blood vessels and vascular bed or anomalies of their development.
• Hereditary factor.

Pathological changes in various parts of the brain (atrophic lesions of the cerebral cortex, evidence of neuronal death, small focal lesions of the brain called lacunar infarctions) detected in patients with VBI during studies indicate that it is necessary not only to diagnose the pathology, but also to determine the cause that caused its development in each specific case. And, if possible, it is necessary to treat the underlying cause first.

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Risk factors

Risk factors for the development of vertebrobasilar syndrome include some congenital vascular pathologies, birth injuries (for example, spinal injuries during childbirth), and genetic predisposition.

There is an opinion that no one is immune from VBN, since some head positions can lead to compression of blood vessels if they are repeated frequently or if a person is in such a position for a long time. This applies to a strong head tilt back, maximum head rotation to the side from a prone position, which happens uncontrollably during sleep, and active head rotation.

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Pathogenesis

The vertebrobasilar system of the body is a combination of 2 vertebral and main arteries with branches extending from it. Accordingly, any violation in one of the components is a blow to the work of the entire system and, of course, the brain, since the system provides its nutrition.

At first, the impaired blood supply manifests itself in the form of minor disturbances in the functioning of the vestibular apparatus, but if the pathology is not treated, a complete cessation of blood supply through the damaged vessel may occur, which is usually the cause of a stroke.

A distinctive feature of vertebrobasilar syndrome is the presence of lesions in the brain. That is, a disruption of blood supply causes damage to the brainstem or bridge of the brain, as well as the cerebellum, occipital lobes or medulla oblongata. Sometimes the process can also affect areas of adjacent blood circulation, as indicated by traces of cerebral ischemia detected in some patients.

The anatomical structure of the spine is such that the vessels running along it are subject to bending in the area of the first cervical vertebra. It is in this place that the vessel most often bends, as a result of which the blood flow weakens, and the brain is "starved".

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Symptoms vertebrobasilar syndrome

Vertebrobasilar syndrome is characterized by two types of symptoms: constant and temporary. Temporary symptoms accompany so-called transient ischemic attacks (TIA), which denote a time-limited disorder of cerebral circulation that takes an acute course and often leads to a stroke.

Typically, such symptoms persist for several hours, sometimes days (usually up to 2 days). During this time, the patient experiences:

• quite severe pain of a pressing nature in the occipital region,
• discomfort in the cervical region,
• quite severe dizziness.

Constant symptoms are those that the patient experiences for a long time. Their severity depends on the degree of development of the pathology. Such symptoms include:

• frequently recurring throbbing or pressing pain in the back of the head,
• tinnitus accompanied by hearing loss, which in advanced cases becomes permanent,
• vision pathologies: objects falling out of the field of vision (gaps), blurred images, double vision, “floaters” or film before the eyes, etc.
• impaired concentration, memory impairment, and the person becomes very absent-minded,
• impaired coordination of movement, manifested in systematic loss of balance,
• when exiting a prolonged uncomfortable position of the neck, dizziness may be observed, often accompanied by nausea and leading to fainting,
• rapid fatigue, significant decrease in work capacity in the second half of the day,
• mood instability, bouts of irritability, which in childhood manifest themselves in the form of causeless crying,
• increased sweating and increased heart rate without any apparent reason, feeling of heat,
• sore mouth, feeling of a lump in the throat, change in voice (becomes a little hoarse).

In childhood, the first signs of the development of VBN are postural disorders, irritability, tearfulness, chronic fatigue and drowsiness, and intolerance to stuffiness.

The sooner the patient pays attention to these manifestations of pathology, the more favorable the treatment prognosis will be. In the early stages of the development of vertebrobasilar syndrome, correction can be carried out even without the help of medications, which cannot be said about the chronic course, which requires the use of various types and methods of therapy, up to surgical intervention.

Vertebrobasilar syndrome in osteochondrosis

The development of vertebrobasilar syndrome against the background of cervical osteochondrosis does not surprise doctors, because it happens very often. Oxygen starvation of the brain in this case occurs precisely because of the compression of the vertebral arteries by the cervical vertebrae, modified due to the disease, past which the path of the vessels lies.

With osteochondrosis of the neck, the following picture is observed: there are disturbances in the intervertebral discs of the cervical region, they change shape, the fibrous ring connecting the vertebrae is destroyed and intervertebral hernias are formed. Cartilaginous tissue is replaced by bone. Which gradually grows, limiting the movement of the neck and causing pain.

These changes cannot but affect the adjacent vessels. They are threatened if not by a spasm, then by a bend due to the deformation of the spine, characteristic of the 3rd stage of osteochondrosis. And since osteochondrosis is still considered an age-related disease, despite the increasing incidence of the disease at a fairly young age, symptoms of vascular atherosclerosis, which also develops with age, can join the degenerative changes in the spine. This only aggravates the situation, and the symptoms of vertebrobasilar syndrome manifest themselves with redoubled force.

The negative impact of the modified cervical spine on the blood arteries nearby reduces blood flow to the brain, causing damage to various parts of it. The cerebellum, for example, is responsible for coordination of movement, which means that its starvation will cause dizziness and loss of balance, and the cerebral cortex is connected to the visual center, which is where blurred vision, double vision, etc. are observed.

The main cause of osteochondrosis, and accordingly VBN, is an unhealthy lifestyle. Lack of exercise, unhealthy diet with excess fats and carbohydrates, poor posture due to incorrect positioning while sitting at a desk, an active lifestyle with nervous tension and stress - these are the factors that provoke the development of pathological changes in the spine. To them we can add various injuries, infections, hypothermia, insufficient physical training, heavy physical labor.

Many symptoms of osteochondrosis and VBN are very similar. These include dizziness accompanied by nausea, changes in blood pressure, impaired coordination of movements, pain in the occipital region, visual and hearing impairment, voice changes, and decreased concentration. If you start treating osteochondrosis in time, without letting the problem progress to surgery, then the manifestations of vertebrobasilar syndrome against the background of osteochondrosis will go away quite quickly.

Complications and consequences

Considering that vertebrobasilar syndrome is accompanied by unpleasant symptoms, the consequences of which are impaired performance and a decrease in the quality of life in general, it makes sense to begin treatment of the pathology itself and its cause as early as possible, preventing complications. Therefore, timely and complete diagnostics are so important.

Moreover, early diagnosis will not only help to facilitate the treatment of VBN, but first of all, will help to prevent various serious complications in the form of stroke and even death.

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Diagnostics vertebrobasilar syndrome

The whole problem in diagnosing vertebrobasilar syndrome is that the combination of its symptoms is not unique. Similar symptoms are characteristic of many diseases, take at least the same osteochondrosis. In addition, there are a couple of nuances that further aggravate the situation. Firstly, the manifestations of the syndrome are strictly individual, and the symptoms in different patients may differ slightly. Secondly, the stories of patients may differ from reality, since here the subjective factor comes to the fore.

And although the doctor's work is not easy, it is necessary not only to diagnose VBN, but also, most importantly, to determine the cause that caused it. Instrumental diagnostics helps to cope with this task, having in its reserve many effective methods and means, which include:

• X-ray of the spine, in particular the cervical spine. It helps not only to determine the condition of the spine itself and its parts, but also to determine the place where a bend has formed or compression of the vertebral arteries occurs.
• Computer/magnetic resonance imaging. Helps to determine the presence of a hernia in the spine.
• Functional tests "flexion-extension". Allows to detect displacement of vertebrae relative to each other, which can cause compression of arteries.
• Ultrasound Dopplerography. With its help, the blood flow through the vessels of the vertebrobasilar system is already assessed: what is its speed, whether there are any violations in the patency of the vessels, etc.
• Infrared thermography. Helps to assess the condition of individual body parts by their thermal fields.
• Duplex scanning, angiography and MR angiography. These methods of examination allow us to study the arteries from the inside: the diameter of the vessels, the condition of their walls, and also to study in detail the cerebral vascular bed.
• Digital subtraction arteriography. One of the effective innovative methods for determining the lumen in vessels.
• Rheoencephalography. This research method is aimed at studying the blood supply to the brain.
• Transcranial Doppler sonography (TCDG). Allows to determine the adaptive capacity of the brain (hemodynamic reserve).
• Otoneurological examination using special equipment. Provides information on the state of the brain stem structures.

If cardiac pathologies are suspected, it may be necessary to conduct functional tests with hyperventilation, which can identify disturbances in the functioning of the cardiovascular system, which can also affect the blood supply to the brain.

And, of course, certain useful information can be provided by tests, in this case a biochemical blood test, which is carried out first.

Since the symptoms of vertebrobasilar syndrome are also characteristic of other diseases, it is very important for the patient to describe his sensations as accurately as possible: the location, nature and duration of pain, when dizziness occurs, how long it lasts, what it is accompanied by, etc. This is very important in order to exclude pathologies with similar symptoms.

Neuropsychological testing helps to assess the objectivity of the patient's complaints, giving a clear picture of how a person perceives his illness and what his psychological state is.

Differential diagnosis

The task of differential diagnostics is to systematize the information obtained from the patient and as a result of the prescribed studies in order to, based on a thorough analysis, give the correct conclusion about the existing pathologies causing vertebrobasilar syndrome.

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Treatment vertebrobasilar syndrome

The choice of methods and means for treating vertebrobasilar syndrome depends on the condition of the vessels and concomitant diseases that caused VBN. But whatever the additional diagnosis, the beginning of treatment implies a change in the patient's lifestyle:

• giving up bad habits,
• feasible physical exercises,
• a special diet rich in fruits, vegetables and seafood with limited salt, bread and baked goods made from premium flour, pickles, smoked foods, etc.

Another requirement of vascular therapy is regular measurement of blood pressure.

In some cases, these measures alone are enough to make the disease recede. If there is no improvement, then after 3-6 months the doctor may prescribe medication and physiotherapy treatment, which can be carried out on an outpatient or inpatient basis.

Drug treatment is carried out using several groups of drugs. Vasodilators play a key role in the treatment of VBN, preventing the occurrence of poorly permeable areas in the vessels, which provoke oxygen starvation of the brain. Such drugs include nicotinic acid, which is a solution of vitamin PP (otherwise vitamin B3), which has a short-term but strong vasodilatory effect.

Nicotinic acid is presented as an injection solution, which promotes the expansion of both small vessels and cerebral vessels. The drug is usually administered intravenously at a dosage of 10 mg (1 ampoule) 1 or 2 times a day. The maximum daily dose is 300 mg. The therapeutic course lasts about 2 weeks.

Taking the drug may be accompanied by the following side effects: hot flashes, reddening of the skin of the face, headache and feeling of heat, significant decrease in blood pressure, dizziness, various allergic reactions, pain when administering the drug.

Precautions: The drug affects concentration, so during treatment you should not perform tasks that require increased concentration.

Contraindications to the use of the drug are hepatitis, gout, ulcerative lesions of the gastrointestinal tract in the acute stage, cirrhosis of the liver, exacerbation of diabetes mellitus, atherosclerosis, hypersensitivity to the drug. Caution should be exercised by patients during pregnancy and breastfeeding, with gastritis, low blood pressure, glaucoma.

Since nicotinic acid is not suitable for the treatment of patients with VBN against the background of vascular atherosclerosis, in the presence of this diagnosis, preference should be given to such drugs as Papaverine hydrochloride, Theobromine, Cavinton, etc.

"Papaverine hydrochloride" is a drug that is simply a godsend for a patient diagnosed with "vertebrobasilar syndrome". Being an antispasmodic, hypotensive and vasodilator drug at the same time, it is even capable of alleviating the symptoms of the disease on its own.

Papaverine is available as an injection solution, tablets for adults and children, and rectal suppositories.

Method of administration and dosage. When taken orally, a single dose is 40-60 mg. Tablets should be taken 3 to 5 times a day.

A single dose for rectal administration is slightly less – 20-40 mg. The procedure is performed 2 to 3 times a day.

In the form of injections, the drug is administered intramuscularly, intravenously or subcutaneously. In this case, a single dose ranges from 20 to 40 ml. When administered intravenously, the papaverine solution is mixed with saline and administered very slowly (the process must be supervised by a doctor!). The interval between injections is at least 4 hours. Such injections can be prescribed from 2 to 4 per day.

Taking the drug may be accompanied by the following side effects: increased nausea, bowel movement disorder, hyperhidrosis, significant decrease in blood pressure, increased drowsiness. If intravenous injections are not administered slowly enough, heart rhythm disturbances may occur.

Contraindications to the use of the drug are: atrioventricular block, glaucoma, severe liver dysfunction, intolerance to papaverine. The drug is intended for the treatment of patients over 6 months. For elderly people, the doses of the drug should be minimal, treatment should be carried out under the supervision of a doctor with dose adjustment. The same applies to patients who have suffered a traumatic brain injury, with renal failure, with supraventricular tachycardia, hypothyroidism, prostate adenoma.

In addition to vasodilators, for VBN, tablets and injections are prescribed to lower blood pressure (antihypertensive drugs), reduce blood clotting (antiplatelet agents), nootropic and metabolic agents (Piracetam, Actovegin, etc.), and, of course, drugs that help relieve the main symptoms (antiemetics, anti-dizziness, painkillers, antidepressants, etc.).

The most common antiplatelet agent is "Aspirin" (acetylsalicylic acid) in a small dosage of 50-100 mg. But, firstly, not all patients experience the desired effect from taking it, and secondly, "acetylsalicylic acid" has a negative effect on the gastric mucosa. That is why it is often replaced by other antiplatelet agents, such as "Dipyridamole", "Ticlopidine" or at least "Cardiomagnyl", in which the negative effect of acetylsalicylic acid on the mucosa is reduced due to a special coating, and the dosage is more convenient.

"Dipyridamole" is an antiplatelet agent with a pronounced vasodilatory effect, intended for the treatment and prevention of cerebral circulatory disorders.

The prescribed doses of the drug can range from 50 to 600 mg per day. This depends on the diagnosis and the degree of development of the pathology. The dosage of the drug and the frequency of its use are determined by the attending physician.

The drug may cause side effects such as increased nausea and vomiting, bowel disturbances, hot flashes and decreased blood pressure, increased heart rate, headaches and dizziness, and allergic skin rashes.

Precautions. "Dipyridamole" is not used in patients with acute myocardial infarction, coronary atherosclerosis, angina pectoris and other heart diseases. As well as with low blood pressure, increased bleeding, severe renal dysfunction.

It is not advisable to use the drug in parallel with caffeine, dobutamine, and drugs that reduce the acidity of gastric juice.

"Piracetam" belongs to the group of noortopic drugs that have found their application in the treatment of symptoms of vertebrobasilar syndrome. It is designed to improve metabolic processes in tissues and blood circulation in the brain. The drug has a stimulating effect on blood microcirculation in the capillaries affected by the disease, acts as a kind of protector of the brain in its damage associated with a lack of oxygen, improves brain activity in general.

The method of administration and dosage of the drug depend on the stage of the disease and the age of the patient. Therapy in adults usually begins with a small dose: 1 tablet 3 times a day, gradually increasing to 2 tablets per dose. If the condition improves after 2-3 weeks, return to the initial dose. In case of stroke, adhere to a maintenance dose of 12 tablets, divided into 3 doses.

Children under 5 years of age are given half the initial adult dose of the drug.

Side effects of the drug are very rare. Sometimes, due to taking Piracetam, dizziness increases, and slight tremors appear. The patient may become more excitable and irritable, his sleep worsens, weakness and drowsiness appear. Various gastrointestinal disorders occur occasionally. In older patients, cases of coronary insufficiency may be observed.

The drug is not prescribed to patients with severe renal failure, hemorrhagic stroke or hypersensitivity to the drug. It is not recommended to use Piracetam in children under 1 year of age, pregnant and lactating women.

In case of dizziness, especially against the background of cervical osteochondrosis, the doctor may prescribe the drug "Betaserk", which reduces the frequency and severity of this symptom of VBN, reduces nausea and tinnitus.

It is recommended to take the drug with food. The dosage is selected individually.

For ease of use, Betaserk is available in tablets of 8, 16 and 24 mg. The daily dose is from 24 to 48 mg, taken in 1 or several doses.

Taking the drug is often accompanied by the following side effects: headache, nausea, indigestion (dyspepsia). Sometimes allergic reactions may occur.

Precautions. The drug is intended for therapy in adult patients and is not recommended for use by persons under 18 years of age. It is contraindicated in case of hormonally active adrenal tumor and hypersensitivity to the drug. Therapy is carried out with caution in patients with bronchial asthma and ulcerative gastrointestinal lesions.

Physiotherapy for vertebrobasilar syndrome

Physiotherapy treatment for VBN is not just an additional therapeutic measure. It is one of the main methods of treating this disease. Without therapeutic gymnastics and physiotherapy, it is almost impossible to achieve a stable positive result.

Therapeutic gymnastics (LFK) is especially useful for osteochondrosis, against which vertebrobasilar syndrome develops. It helps to strengthen the spine, correct posture, and relieve muscle spasms.

Therapeutic massage performed by specialists will help to significantly improve blood circulation.

Manual therapy, often used for spinal pathologies, is also not left aside. If there are vascular diseases, hirudotherapy using leeches will give a positive effect.

Of the reflexology methods, the greatest effect is achieved with acupuncture, which helps effectively relieve spasms and pain in the muscles of the cervical spine.

Magnetic therapy methods are indicated for VBN and cervical osteochondrosis. The influence of low frequencies helps to eliminate dizziness, pain in the occipital region, and increase performance.

In some cases, the doctor prescribes such a conservative measure as wearing a cervical corset, which prevents compression of the blood vessels in the neck area.

If there is no positive effect even after prolonged treatment with medications and physiotherapy methods, surgical treatment is prescribed, the purpose of which is to improve blood circulation in the vertebral and basilar arteries.

Most often, angioplasty (vascular stenting) is required. In this case, a special stent is inserted into the artery, which prevents narrowing of the lumen inside the vessel and circulatory disorders.

In the presence of a hernia in the cervical spine, microdiscectomy (removal of a small piece of bone tissue) is very often prescribed, which prevents compression of the vessels that supply oxygen to the brain.

Endarterectomy is a surgical procedure that allows removing atherosclerotic plaques from vessels. It is indicated for atherosclerosis, against which vertebrobasilar syndrome can also develop.

Traditional treatment of vertebrobasilar syndrome

Traditional medicine specialists have long noticed that there are many food products that can affect blood clotting. These products include berries (sea buckthorn, cranberry, viburnum, currant, etc.), fruits (lemon, orange, kiwi, etc.) and vegetables with a high content of vitamin C. They thin the blood well and prevent the formation of blood clots in the vessels.

The well-known bitter healer garlic also reduces blood clotting. To do this, mince 3 good heads of the hot vegetable, put them in a jar and store them in a cool place without access to light for 2-3 days. Then add the same amount of honey and freshly squeezed lemon juice to the mixture. Use the mixture at night in the amount of 1 tablespoon. Store in the refrigerator.

For the same purpose, in case of vertebrobasilar syndrome, a decoction or tincture of horse chestnut seeds is used. For the tincture, 100 g of seeds are poured with 300 g of vodka and infused for 7 days, after which they are filtered and taken 2-3 times a day half an hour before meals.

Infusions of rose hips, rowan or currant, rich in flavonoids and vitamin C, help strengthen the walls of blood vessels and increase their elasticity.

Seaweed, chokeberry, hawthorn, and clover infusion help to lower blood pressure. To prepare the infusion, pour 2 tablespoons of herbs with a glass of boiling water and leave for about an hour. Take the infusion before meals, 2 tablespoons.

With VBN, herbal treatment gives good results. To reduce blood pressure, we can recommend the following herbal mixtures: lemon balm and corn silk or rue, mint, corn silk and valerian. And as a vasodilator mixture - a composition of St. John's wort, chamomile, immortelle, yarrow and birch buds, taken in equal quantities (1 tbsp. mixture per 0.5 l of boiling water).

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Homeopathy for Vertebrobasilar Syndrome

The range of homeopathic preparations that help improve cerebral circulation in one way or another is very large; it is important to select exactly those preparations that give the best effect in the treatment of the diseases that a particular patient has that have caused the development of vertebrobasilar syndrome.

For example, in case of cervical osteochondrosis, a good effect is observed when using the homeopathic preparation with a rich herbal composition "Traumeel S", which removes pain, stops the inflammatory process and helps to restore damaged spinal discs.

Method of administration and dosage. Like any homeopathic tablets, Traumeel S should be placed on the tongue and held there until completely dissolved. Tablets should be taken a quarter of an hour before meals. The daily dose is 3 tablets, taken in 3 doses.

In parallel with taking the tablets, you can use the ointment and make intramuscular injections of the drug (1-2 ampoules 1 to 3 times a week).

The course of treatment lasts no more than 8 weeks.

During the administration of the drug, allergic reactions, irritation at the injection site, and increased salivation may occur.

Precautions: The drug is not used in tuberculosis, leukemia, multiple sclerosis, autoimmune diseases and hypersensitivity to the components. Not indicated in the treatment of children under 12 years of age.

To reduce dizziness associated with atherosclerosis, therapy with the drug "Edas-138" in the form of homeopathic drops is indicated.

The drug can be used in 2 ways: 5 drops can be dropped on a piece of sugar or dissolved in a tablespoon of water. It is recommended to take the drug 3 times a day.

The drug is well tolerated if there is no intolerance reaction to the components of the drug.

In case of atherosclerosis of vessels, the herbal preparation "Dihydroquercetin" is also indicated, which strengthens vessels and improves microcirculation of blood and cholesterol in vessels. It is taken in the following dosage: 2-3 tablets 1 to 4 times a day.

The most popular and effective drugs for improving both cerebral and peripheral blood circulation are homeopathic remedies based on ginkgo biloba. One of these drugs is "Bilobil", which reduces the permeability of the vessel walls and prevents the formation of blood clots.

The drug is available in capsule form, which should be taken 3 times a day with water. Single dose - 1 capsule.

The homeopathic remedy is taken over a long period. Although improvement occurs within 1 month of treatment, the therapeutic course must be carried out for at least 3 months.

Side effects of the drug include symptoms such as headache, sleep disturbances, bleeding due to decreased blood clotting, and allergic reactions.

The drug is contraindicated in hypersensitivity reactions, low blood clotting, erosions and ulcers in the gastrointestinal tract, myocardial infarction, as well as acute cerebrovascular accidents. It is not used in pediatrics and therapy of pregnant women.

To replenish the body's reserves of B vitamins, which is so necessary in the treatment of vertebrobasilar syndrome, you can use a homeopathic remedy that has proven itself as an eye medicine. We are talking about "Blueberry Forte" tablets.

The drug should be taken 2 tablets 2 times a day. It is best to do this during meals. The course of treatment is up to 4 months.

In childhood, the possibility of using the drug and the dosage should be agreed with the doctor.

The only contraindication to the use of the drug is intolerance to its components, which may lead to allergic reactions.

Prevention

The goal of preventive measures to prevent vertebrobasilar syndrome is to prevent the development of diseases that cause symptoms of VBS. To do this, you need to:

• Practice a balanced diet with restrictions on fried and fatty foods, white bread, sausages and smoked foods, and pickles.
• Give up bad habits.
• Reduce salt intake to a minimum.
• Lead an active lifestyle with moderate physical activity and time spent outdoors.
• Avoid stressful situations.
• Monitor your posture during sleep and wakefulness.
• Monitor your blood pressure constantly.

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Forecast

The prognosis of vertebrobasilar syndrome directly depends on the degree of development of the underlying disease that caused VBN. However, it is influenced by the following factors: the correctness and timeliness of the diagnosis, the effectiveness of the prescribed treatment, the quality of the patient's compliance with the doctor's orders.

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