I65.09

Clinical Causes: Atherosclerosis (build-up of fatty deposits within artery walls) Blood clots (thrombosis) forming within the artery Emboli originating elsewhere that block the vertebral artery Vascular inflammation (vasculitis) Congenital vascular abnormalities Trauma or injury to the neck or vertebral arteries Degenerative changes associated with aging Associated conditions like hypertension or high cholesterol levels

Key Symptoms: Dizziness or vertigo Drop attacks (sudden episodes of falling without loss of consciousness) Unilateral or bilateral visual disturbances Neck pain or stiffness Difficulty speaking or swallowing Weakness or numbness on one side of the body Difficulty with coordination and balance Headaches, especially at the back of the head Transient ischemic attacks (brief strokes) or, in severe cases, stroke

Diagnosis Path: Diagnosis typically involves a combination of clinical evaluation and imaging studies. Healthcare providers may perform neurological assessments to identify deficits and symptoms related to posterior circulation. Imaging techniques include: - Ultrasound Doppler studies to examine blood flow in the vertebral arteries - Magnetic resonance angiography (MRA) for detailed visualization of the arteries - Computed tomography angiography (CTA) to identify areas of narrowing or blockage - Conventional angiography, sometimes reserved for definitive diagnosis and intervention planning. These tests help determine the extent and location of stenosis or occlusion, guiding treatment options.

Treatment Protocols: Management of occlusion and stenosis of the vertebral artery focuses on preventing stroke and restoring adequate blood flow. Treatment approaches may include: - Lifestyle modifications such as a healthy diet, regular exercise, smoking cessation, and controlling blood pressure and cholesterol levels - Medical therapy with antiplatelet agents (e.g., aspirin) to prevent clot formation - Addressing underlying risk factors like hypertension, diabetes, and hyperlipidemia - Endovascular procedures such as angioplasty or stenting to widen narrowed arteries - Surgical interventions in select cases, including bypass surgery or vascular reconstruction - Regular monitoring through imaging to assess disease progression It is essential to consult healthcare professionals for personalized management tailored to the severity of the condition and individual risk factors.