Abstract
Introduction Vertebrobasilar insufficiency is defined as transitory ischemia of the vertebrobasilar
circulation. Dizziness, vertigo, headaches, vomit, diplopia, blindness, ataxia, imbalance,
and weakness in both sides of the body are the most common symptoms.
Objective To review the literature regarding the three available diagnostic testing in patients
with dizziness complaints secondary to vertebrobasilar insufficiency (VBI): magnetic
resonance angiography; transcranial Doppler ultrasound; and vertebrobasilar deprivation
testing.
Data Synthesis We selected 28 studies that complied with our selection criteria for appraisal. The
most frequent cause of the hemodynamic changes leading to VBI is atherosclerosis.
The main clinical symptoms are dizziness, vertigo, headaches, vomit, diplopia, blindness,
ataxia, imbalance, and weakness in both sides of the body. Even though arteriography
is considered the most important exam to diagnose the disease, the inherent risks
of this exam should be taken into consideration. The magnetic resonance angiography
has been widely studied and is a good method to identify and localize any occlusions
and stenosis in both neck and intracranial great vessels.
Conclusion Each patient with a suspected diagnosis of VBI should be individually evaluated and
treated, taking in consideration the pros and cons of each diagnostic testing and
treatment option.
Keywords
vertigo - ischemia - stroke - vertebrobasilar insufficiency - dizziness - pathophysiology
