International Medical Journal, Vol. 22., Iss. 4, 2016, P. 73−76.
ANATOMICAL AND PHYSIOLOGICAL CONDITIONS OF THE VERTEBRAL ARTERY SYNDROME
Kharkiv Medical Academy of Postgraduate Education, Ukraine
One of the most important etiological factors of chronic hemodynamic disorders in the vertebrobasilar basin, especially in young people, is vertebral artery syndrome (SPA), (G 99.2 in ICD−10) including posterior cervical sympathetic syndrome, recurrent episodes of vertebrobasilar insufficiency, drop attacks and Unterharnscheidt's syndrome. There are a number of anatomical and physiological prerequisites for development of hemodynamic disorders in the vertebral artery system. An important feature of hemodynamics in the vertebrobasilar basin is that for development of disorders of blood circulation, persistent occurrence of functional blockades of the vertebral−motor segments is enough, which is possible even in children. However, despite the understanding of the pathogenetic mechanisms of the development of individual vertebral artery syndrome, to date the question the impact of myofascial dysfunction, neck and shoulder and localization biolocomotive spine disorders in general, the occurrence of symptomatic vertebral artery compression remains understudied. All these issues require further study and systematization. The leading pathogenetic mechanisms of vertebral artery syndrome, according to the majority of authors, are compression of the artery, vegetative plexus and narrowing of the lumen of the vessel due to reflex spasm resulting from the inferior oblique muscle tension in the head and anterior scalene muscle, which leads to reduction in the blood supply of the posterior division of the brain and development of circulatory insufficiency in the vertebrobasilar basin. However, the question about the impact of myofascial dysfunction of the neck and shoulder and biolocomotive spine disorders in general on the occurrence of symptomatic vertebral artery compression remains understudied. The criteria of pathobiomechanical changes that cause this syndrome have not been worked out, there is no differentiated therapeutic approach to treatment of such patients. All these issues require further study and systematization.
Key words: vertebral artery, vertebrobasilar pool, hemodynamic abnormalities, vertebral artery syndrome, biomechanical disorders, myofascial dysfunction.