Abstract

Transient ischemia within the posterior circulation supplied by the vertebrobasilar artery system is a common cause of episodic dizziness in older patients. Vertebrobasilar insufficieny (VBI) has been used as an umbrella term indicating a hemodynamic cause of all cases of posterior-circulation ischemia. VBI could show the characteristic combination of symptoms such as diplopia, visual field defect, ataxia, motor weakness, hearing loss and sensory change. However, occasionally vertigo can occur in isolation. The symptoms of VBI usually come on abruptly, last a few minutes, and then end abruptly, usually with minimal or no residual symptoms. As a rapidly advancing technology for noninvasive imaging of cerebral arteries like magnetic resonance angiography, conventional cerebral angiography has been substituted even though it is still the gold standard. VBI could be treated by a proper medical treatment with antiplatelet agents or anticoagulants and by a control of vascular risk factors (i.e., hypertension, diabetes, hyperlipidemia, smoking, etc.). Also there are increasing evidences that vertebrobasilar angioplasty and stenting may become important therapeutic strategies for large-artery vertebrobasilar disease.