Peripheral Arterial Disease (PAD) Expert Forum
diminutive vertebral artery
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diminutive vertebral artery


Hi - I am a 29 yr old female with a history of coarctation of aorta, repaired 15 yrs ago. I also have a bicuspid aortic valve which is unrepaired.

I have been seeing a physical therapist for the past 3 months for a headache which won't go away! It's at the back of my head, at the base of skull.

About 2 weeks ago, during some neck rotations I nearly fainted. The physiast told me it's technical term was "vasovagal pre-syncope".

Anyway, to cut a long story short, I was sent for an MRA. The report states "The entire visualized left vertebral artery is developmentally diminutive and the corresponding right vertebral artery is developmentally dominant".

1. Could you explain the consequences of the above findings?

2. Also, does this explain my constant headaches?

I appreciate your assistance, thanks.
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Hello
60% of people have a discrepancy in vertebral artery size with a dominant rt or left verterbral and an atrophic or diminutive opposite vertebral. It is unlikely that this congenital finding present since early in your life is responsible for your headache.

The primary circulation to the brain is provided thru the carotid vessels in the anterior brain. It would be very difficult to cause a blockage of these vessels transiently that would produce fainting. Transient occlusion of the dominant vertebral should cause an unstable gait, not fainting. Your therapist is probably correct re: the cause although it would probably be a good idea to have your pcp give you the once over if you plan to continue with therapy.

Good luck with determining the cause of your headaches
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