One of the most common causes of vertigo and instability by elder people is a disorder of the brain blood supply, especially affecting the back circulation of the brain, more specifically vertebrobasilar area. The reasons why it happens are artheriosclerotic changes (the wall of the artery thickens and loses its elasticity) of the afferent cerebral and intracranial arteries happening simultaneously with degenerative changes in the cervical spine. Such condition then leads to lack of blood supply to the vertebral artery when we bend our head.
When we talk about vertebrobasilar (VB) area (blood flow in the vertebral, basilar and back artery of the brain) we mean the area of the brainstem, cerebellum, back of the neck and partly also the frontal lobes of the brain. Vascular supply of this area is quite often affected by atherosclerotic process, which simply means the blood vessels are getting narrower.
Symptoms of this illness are depending on the extent of the disorder of blood supply, how fast it developed, and how long does it affect the VB area, but also carotid arteries. There are typical disabilities affecting the VB area such as brainstem and cerebellum symptoms manifesting as vertigo, bad articulation, double vision, sensitivity and mobility disorder, movement coordination disorder, walking and standing disorder, memory and consciousness disorder.
We focus on the circumstances of the creation of these problems, when patient complains about vertigo during a head bend, or when looking up, when hanging clothes and other various activities where bending your head is required. Sometimes it can also lead to falling down, and being unconscious for a short period of time.
Clinically we exclude the presence of vertigo with other symptom - absence of nystagmus (involuntary eye movement).
According to medical history (anamnesis) we usually find out the presence of dizziness (functional symptoms, hearing disorder, tinnitus), alternatively we observe and examine the presence of other possible neurological manifestations (mobility and sensitivity, speech disorders, smelling and taste disorder, headaches, sight sharpness, diplopia - double vision, disorder of field of view, consciousness disorders).
In therapy with neuromuscular techniques, we relief the soft tissues and mobilize them very gently because of the affected area of the cervical spine. We recommend you rehabilitation treatment focused on training the movement stereotypes, rhythmic stabilization and functional rehabilitation of the cervical spine.
We usually observe a positive effect of the therapy on our clients. But it is important to warn the patient about what causes the problem, and avoid activities during which they bend or turn their head.
Author: FYZIOklinika physiotherapy Ltd., Prague, Czech Republic
Source: Clinical experience in private practice and physiotherapeutic field, FYZIOklinika