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Vertebrobasilar Insufficiency!!!

Can anyone shed any light on what this is please??? I have just had an Occupational Health assessment and it has written on my report to discuss this with my Neurologist as a possible cause of my Chronic Vestibular Migraine. He SEEMED quite clued up about this condition. Has anyone heard of this or better still been tested for it as a cause of their MAV??
Thanks in advance
Jo xx

There’s a wikipedia page for it, apparently!

Thanks James

I think he Dr i spoke to was trying to rule out any possibilities of a cause…as i always 100% blame menopause and he said not to ASSUME things even though he said its very plausable. I know a lot of people here have had all sorts of scans on their necks and was hoping they may have had this done…whether my neurologst will adhere to the Drs suggestion remains to be seen. I had a brain MRI not sure if this would cover all of this.
Jo x

OMG fancy having to try to explain that to someone in Tescos, eh.

Never heard of that one before. I think you’ll find it would be picked up on MRI brain scan as the related arteries are back of head. Read the Wikipeadia site on it see if you fit the symptoms and criteria. I’ve just checked mine. I only meet the age criteria. Couldnt see any mention of chronic dizziness more a case of positional stuff more like BPPV and mentions it promptly resolving by one quick scan read. Occurs most usually in the elderly and men at that. Interesting one though. Was it neurologist you saw with Occupational Health?

Only thing really resonsants with me is the restricted bloodflow. (I’ve got it today, had it all day so far) I’ve always felt the head tightness seemed like something’s restricted, or inflammation. Too much ‘stuff’ trying to occupy too tight a space. However with me as this was one of the last symptoms I developed would seem odd that could do cause.

If I was you I’d want to speak to your neuro PDQ to see what she says. Helen

No flies on me Helen…ive already rang her secretary to pass on the information. It was a Dr who assessed me yesterday via telephone. I explained the “hanging out washing” trigger and the terrible motion intolerance amongst other things. He said hes seen patients with BAD migraine in youth, no symptoms in their 20s 30s then chronic from 40s onwards so he absoutely agrees with hormones as a cause BUT he thinks some of my triggers are positional from my description as well as stimuli and environmental AND i always complain about my nose feeling like it will burst with pulsating sensations so he said its worth checking out…we’ll see what my lovely young neurologist has to.say. it COULD make sense i suppose…a blood flow issue.
Jo xx

Jo xx

Hi Jo. Yes, a blood flow issue could make sense. Could be the catalyst that combined with hormones if not to actually cause MAV but to impede recovery. Since I’ve had these tightened head and what I now call my,’hamster ears’.which isn’t overlong, I’ve often wondered if it could be something of that sort, not that I had ever heard of Vertebrobasiliar Insufficiency until today. Knowing our seeming similarities, I haven’t pegged out washing for years and years either, I will be fascinated to hear developments. Helen

i got this ruled out via an MRA.

Ahhh thanks for that…looks like i may be having it ruled out too…is it completely different from a normal MRI brain scan?
Jo x

its similar, it looks for blood flow

It is a pinching of your vertebral artery. You can do an MRA/MRI of the neck and see the pinching if any. It is extremely rare. Also a normal brain CT has a top view and in some case you can see if there is any compression of the artery. I spoke at length about this to my neurologist and she said anatomically even if you did pinch, there are two nerves on either side and the signals will still make it through. good luck figuring this out.

Thanks Vigs
I have lot of faith in my neuro and think if she had thought there was a chance this could be a cause she would have ruled it out. She may or may not act upon it. Got to admit though ive never had any tests on my neck
Jo x

Apparently it would appear the same to the patient, same machine and same procedure, but looks at blood vessels primarily and to enhance it usually they inject a dye first into yr system.

Just had a reply from Headache Specialist Nurse…she is going to disscuss it with my Neuro on Monday and get back to me.
Jo x

Oh why do all these things always happen on a Friday! I shall have to try not to hold my breath til Monday. Might have side effects, eh. To be serious and, being the cynic I am, the Occupational Health Dept.’s paid for by yr employer. Now let’s suppose you had a VI diagnosis. That’s caused by heart/circulation problems which wouldn’t/couldn’t possibly be laid at the door of your employer under any even distant Health & Safety umbrella but Migraine. At a push, and I admit a real good stretch, may be the lights at work could have caused your problem, and you might decide it worth perusing some financial claim against them in the future. Just a thought.

There seem to be lots of similarities between the two conditions if you have a look in more detail but also alot of differences. It will be very interesting to hear what yr consultant says. Seems at least with VI, a MRA would be definitive one way or the other. Apparently it’s extremely rare. As it seems is info on line relating to it.

Postscript: on the porthosp.nhs.uk website found this bit of info relating to Vertebrobasiliar Ischaemia (restriction in blood supply to tissues) in document advising GPs on referral criteria etc for Dizziness, Vertigo, Imbalance. It states it’s ‘grossly over/misdiagnosed. Many of these patients have BPPV. Only consider if other posterior circulation symptoms/signs (Facial numbness, dysarthria, diplopia etc)’. . Helen
Postscript: on further reflection these symptoms are posterior circulation TIA’s symptoms, the type that GP’s test for by observing direction of nystagmus, sticking pins in extremities, ‘follow my finger; exercises at bedside during acute attacks-of unexplained vertigo. Under NICE ~guidelines they are legally required to eliminate the possibility of stroke etc in cases of ‘older’ patients. I’ve suffered the indignity myself.

I will let you know what the outcome is Helen…looking at old posts quite a few people have had MRA 's…and were negative
Jo x

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Just as well. If one had to make a choice - and it certainly would be Hobsons Choice that one - I guess I’d go for MAV in preference to VI. Clogged up arteries don’t appeal still one treatment option is aspirin and I could take that in fact it was only thing I would take for my childhood ‘sick’ headaches. Helen

Was he rather basing his thoughts of VI on the significance of ‘hanging out washing’. Do you think. I wondered about it being caused by blood flow issue years back when I used to go to bed fine and wake up with full-on vertigo attack time after time. Kept wondering if I was sleeping awkwardly and trapping something someshere so blood didn’t flow. Had no idea if that is even possible but did keep wondering.

What washing out symptoms do you suffer. I found (past tense because He has hung out/pegged in ours four years now probably longer) it just made me even more unsteady on my feet. Not sure if it ever caused immediate vertigo, don’t think so. I’d always put this phenomenon down to the looking up at the washline reduces balance info from vision by taking the eyes away from using the horizon as a marker to keep one upright when other bits are lacking in their ability to supply info to the brain. Bit like stealing away one’s walking stick really. Looking up variations of the Romberg recently I noticed some use the looking up whilstperforming Romberg as a step between eyes closed and ines opened which appears to prove my point. Surely, only thing it’s diagnostic of is reacting to self movement which is a typical MAV symptom be interesting to see what transpires though. Helen

Well…the head honcho says " no" theres no need to be scanned for VI as my neck was all checked along with my brain scan…and yes like you i think i get dizzy just looking up OR down when im ironing is another trigger. Im just dizzy moving my head in general.
Jo x

Yes, self motion, most particularly head motion always got to me and it’s typical MAV symptom. Certainly one of my most regular symptoms. Eased off quite considerably these days.

So the VI was another ‘red herring’, eh. Talking of food, You haven’t been told to do any special diet have you by yr young neurologist. What abt caffeine? I was told quite categorically not to bother with either but do wonder. I’m much better most of the time, in fact had two perfect days recently, both Wednesdays as it happens, but wonder what else I could do that might help. Looking at Dr S’s diet I’d want to know what you can eat. Whatever do you put in a sandwich, not eggs, no cheese, no processed meat, yes, but what? I don’t do fish but very rarely. I’d starve to death on that. Maybe that’s a cure in a way but a bit of a drastic one I thought. Helen

Wow Helen…2 perfect dsys!!! What i would give🙄 ive had to take Zolmitriptan today my nose was about to split open!!! Why does that happen? Is it blood vessels or nerve endings or both?? I have never been asked to do any sort of diet whatsoever. I just cut caffeine out myself. Dont think its making one bit of difference Helen. My nose and ears have been terrible lately…how my nose doesnt bleed or split i’ll never know!!!
Jo x