Treatment of vertebrobasilar insufficiency in a neurosurgical hospital // Studienergebnisse zur Behandlung der vertebrobasilaren Insuffizienz in einer neurochirurgischen Klinik

摘要

This article presents the treatmentoutcomes for 100 patients with vertebrobasilarinsufficiency (VBI) associated with tortuosityof the V1 segment of the VA, who were dividedinto 2 groups: surgical (n = 50) and conservativetreatment (n = 50). Together with conventionaldiagnostic methods used to clarify the tacticsof surgical treatment (Doppler ultrasonography,contrast-enhanced multi-spiral computed tomography) a proposed method to determine VAreactivity and impaired blood flow in the VBSis a key method for the prediction of clinicaloutcomes following surgery on the VBS arteries. Cerebral angiography is recommended inall patients before surgery on the VBS arteries,in order to determine the state of the intracranial part of the vertebral and main arteries,as outflow paths, and to determine collateralcompensation in the VBS. Further use of reconstructive techniques on the V1 segment ofthe VA show better distant clinical outcomes.Tortuosity resection in the V1 segment of the VAis most effective in the immediate postoperative period and is used in patients with multiplelesions of the arteries as the first stage to increase the resistance of the brain to ischemiain subsequent reconstructive surgery. The useof conservative treatment in patients with concomitant lesions of the VBS is possible. Immediate outcomes are satisfactory.