Clinical Analysis Of 265 Patients With Vertebrobasilar Insufficiency

Object and Method: In order to make further researches in-toVBI about etiologic factor, pathogenesis, the difference of etiologictype at the different age period and sex, to explore theprognosis, 265patients with VBI from the first Hospital of JilinUniversity fromJanuary to October 2005 were selected to have a perspective study.TCD, CDFI and hemorrheology were detected. And have a follow-upvisit after 6 months. Results: Most patients are between 50 and 60 years of age.Female is a little more than male .It is a clinical symptom-complexwith multy etiologic factors. The type of vasospasm accounts for 16%,and arteriosclerosis with slow blood flow 34%, vertebrobasilar arterystenosis 12%, anterior circulation artery stenosis and steal syndrom8%, subclavian steal syndrom 2%, hyperviscosity 6%, cervicalsyndrome 7%, VA dysplasia 7%, others 8%. The etiologic type isdifferent between male and female at the group of younger than 50years old. Vasospasm is the main type of female, while male arevasospasm and arteriosclerosis. There is no significant deviationbetween male and female at the group of older than 50 years old andtotal. When incidence of arteriosclerosis is mentioned, there is nodifference at the group of older than 50 years old and total, while thesignificant deviation between male and female presents at the group ofyounger than 50 years old. Patients with slow blood flow of VAaccording to TCD can be discovered no abnormality 49.56%,endangium thickening and plaque formation 19.13%, VA stenosis4.35%, subclavical stenosis 4.35% and VA dysplasia 16.52% withCDFI. In the group of dissymmetry, patients with angiostenosis andVA dysplasia are more than those in the group of symmetry. Thefollow-up visit results are rate of cure 57.74%, recurrence 36.60%,new cerebral infarction 3.77%, TIA 1.89%. The incidence of cerebralinfarction in type of VBA stenosis and anterior circulation arterystenosis and steal syndrom is 18.87%. The incidence of cerebralinfarction in the type of anterior circulation artery stenosis and stealsyndrom is 33.33%, while VBA stenosis 9.38%.Conclusions: (1) Most patients are between 50 and 60 years old.(2) With TCD, CDFI and hemorrheology we can induce VBI into 9types. (3) The etiologic construction is different between male andfemale at younger than 50 years old group. The incidence ofarteriosclerosis of female is lower than that of male. (4) It is importantto have a further detection when we discover the blood flow isasymmetrical according to TCD. (5) The prognosis of VBI is differentfrom TIA. (6) Patients with angiostenosis, especially withantero-circulation artery stenosis and post-circulation arterycompensation, have a higher incidence of cerebral infarction thanother types.