List 4 intrinsic causes of vertebrobasilar insufficiency.

List 4 extrinsic causes of vertebrobasilar insufficiency.

What is a pseudoaneurysm and what danger does this present to the patient?

List 5 symptoms that may be caused by vertebrobasilar insufficiency.

List 5 signs that may be caused by vertebrobasilar insufficiency.

What is the average age for stroking from vertebrobasilar injury or disease?

Atherosclerosis, thrombus formation, embolus, hypertensive hemorrhage, intimal/media tears, fibromuscular dysplasia.

Disc prolapse, blunt/penetrating trauma, cervical osteophytosis, cervical instability, fractures, therapeutic manipulation, exercise.

This follows an intimal/media tear where the flow of the blood strips the intima and media away from the adventitia and then the pressure causes the adventitia to balloon outwards. The danger is that the pseudoaneurysm can rupture spontaneously (usually within 12 days) or can be ruptured by movement or manipulation.

Dizziness (presyncopic in 100% of cases and vertiginous in 40%), bilateral, quadrilateral or hemilateral parasthesia, perioral numbness/tingling, facial parasthesia, diplopia, tinnitus, hypoacusia, scintillating hemi/quadranopia, headaches, dysphagia.

Drop attacks, nystagmus, ataxia, bilateral, quadrilateral, hemilateral and/or facial pain and temperature sensation loss, dysmetria, demonstrated hemi/quadranopia, demonstrated hypoacusia, dysarthria, dysphasia, dysphonia, Horner's syndrome.

37 years with a spread between 9 and 98 years. It is not an old person's problem.