Dizziness can be caused byproblems with your inner ear due to infection and other diseases, or as we get older from a build-up of fat in the arteries, called plaque. These symptoms need to be checked over with your GP.

In the neck, there are small arteries that run through the cervical spine and enter into the base of the brain via the major opening called the foramen magnum. If the upper cervical spine joints get irritated this can affect these arteries and cause them to constrict which also causes dizziness. It can happen when there is arthritis of the neck and as you look up or to the side you start to get dizzy or giddy. If you have these symptoms alone then osteopathic treatment may well help by improving upper neck function thus freeing off these blood vessels.

Restricted blood to the base of the brain due to atherosclerosis needs to be checked out fully with your GP. The problem is called vertebro basillar insufficiency (VBI)

The condition that can be helped by osteopathy is transient VBI,which means it is temporary, due to change in position of head neck or stress.

What is vertebrobasilar insufficiency?

The vertebrobasilar arterial system is located at the back of your brain and includes the vertebral and basilar arteries. These arteries supply blood, oxygen, and nutrients to vital brain structures, such as your brainstem and cerebellum.

A condition called atherosclerosis can reduce or stop blood flow in any artery in your body, including the vertebrobasilar system

Atherosclerosis is a hardening and blockage of the arteries. It happens when plaque that’s made up of cholesterol and calcium builds up in your arteries. The build-up of plaque narrows your arteries and reduces blood flow. Over time, plaque can severely narrow and completely block your arteries, preventing blood from reaching your vital organs.

When the blood flow in the arteries of your vertebrobasilar system is significantly reduced, this condition is known as vertebrobasilar insufficiency (VBI).

What causes VBI?

VBI occurs when the flow of blood to the back of your brain is reduced or stops. According to research, atherosclerosis is the most common cause of the disorder.

Who’s at risk for VBI?

Risk factors for the development of VBI are similar to those associated with developing atherosclerosis. These include:

• smoking
• hypertension (high blood pressure)
• diabetes
• obesity
• being over the age of 50
• family history of the disease
• elevated levels of lipids (fats) in the blood, also known as hyperlipidemia

People who have atherosclerosis or peripheral arterial disease (PAD) have an increased risk for developing VBI.

What are the symptoms of VBI?

The symptoms of VBI vary depending on the severity of the condition. Some symptoms may last for a few minutes, and some may become permanent. Common symptoms of VBI include:

• loss of vision in one or both eyes
• double vision
• dizziness or vertigo
• numbness or tingling in the hands or feet
• nausea and vomiting
• slurred speech
• changes in mental status, including confusion or loss of consciousness
• sudden, severe weakness throughout your body, which is called a drop attack
• loss of balance and coordination
• difficulty swallowing
• weakness in part of your body

The symptoms can come and go, as in a transient ischemic attack (TIA) which needs to be differentially diagnosed from transient ischaemia due to purely upper cervical spine problems – arthritis and neck tension

The symptoms of VBI are similar to those of a stroke. Seek emergency medical care if you experience these symptoms.

Immediate medical intervention will help increase your chance of recovery if your symptoms are the result of a stroke.

How is VBI diagnosed?

Your doctor will perform a physical exam and run a series of tests if you have symptoms of VBI. Your doctor will ask you about your current health conditions and may order the following tests:

• CT or MRI scans to look at the blood vessels at the back of your brain
• magnetic resonance angiography (MRA)
• blood tests to evaluate clotting ability
• echocardiogram (ECG)
• angiogram (X-ray of your arteries)

In rare cases, your doctor may also order a spinal tap (also known as a lumbar puncture).

How is VBI treated?

artery). Your doctor can recommend several different treatment options depending on the severity of your symptoms. They’ll also recommend lifestyle changes, including:

• quitting smoking, if you smoke
• changing your diet to control cholesterol levels
• losing weight, if you’re overweight or obese
• becoming more active

Additionally, your doctor may prescribe medications to help reduce your risk of permanent damage or stroke. These medications may:

• control blood pressure
• control diabetes
• reduce cholesterol levels
• thin your blood
• reduce coagulation of your blood

In some cases, your doctor may recommend surgery to restore blood flow to the back of the brain. Bypass surgery is an option as is an endarterectomy (which removes plaque from the affected

How can VBI be prevented?

Sometimes VBI can’t be prevented. This can be the case for those who are aging or those who’ve had a stroke. However, there are steps that reduce the development of atherosclerosis and VBI. These include:

• quitting smoking
• controlling blood pressure
• controlling blood sugar
• eating a healthy diet that’s rich in fruits, vegetables, and whole grains
• being physically active

What’s the long-term outlook?

The outlook for VBI depends on your current symptoms, health conditions, and age. Younger people who experience mild symptoms and control them through lifestyle changes and medication tend to have good outcomes. Advanced age, frailty, and strokes can negatively affect your outlook.