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Chiropractic Care (Expert Forum)
diminutive vertebral artery
Answered by
Adam R. Tanase, D.C. - Upper Cervical Care, Wellness, chiropractic
Big Idea Clinic
St. Louis - MO
Questions in the Chiropractic Care Forum are being answered by Dr. Adam Tanase, a board-certified Doctor of Chiropractic. Topics covered include Muscle Pain, Nerve Pain, Movement Disorders, Subluxation, Upper Cervical Care, Pain Management, Health Care Alternatives, and Wellness Care
diminutive vertebral artery
by Kim867, May 23, 2008 06:02PM
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.
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.
Doctor's Answer
by Adam R. Tanase, D.C., May 23, 2008 11:31PM
, May 23, 2008 11:31PM
To: Kim867
Kim,
Thanks for your question. An MRA is an imaging study that produces pictures of the body’s major blood vessels.
A pair of vertebral arteries travel down the sides of your neck. These vessels were analyzed during the MRA. The report is basically telling you that the left vertebral artery is noticeably thinner/smaller than the right one.
I cannot tell you that having one vertebral artery thinner than the other is going to induce suboccipital headaches. Due to the location of your headaches, I would suspect that the atlas, or C1 vertebra at the top of your neck is misaligned, and getting uncomfortably close to either the base of your skull (occiput) or to the posterior arch of axis, C2.
Rotation of the head, coupled with extension (looking up) is a bad recipe for anyone with significant arterial asymmetry of this nature. While chiropractic adjustments are extremely safe, due to the potential significance of a diminutive artery, I would recommend against manual rotational movements of the head/neck – regardless of which professional performs them (PT, DC, DO, or MD).
I would also recommend that you use caution when washing your hair. Many people extend their heads to rinse their hair, and this position could duplicate the movements your PT performed, and cause you to experience the “vasovagal pre-syncope” again.
You might consider consulting an Upper Cervical Chiropractor and share your MRA findings with him. But make sure the DC you choose is an exclusive Upper Cervical specialist (there are approximately 500 in the US). They’ll take unique x-ray views of your neck, and will be able to determine if an upper cervical misalignment is causing your headaches.
Ultimately, it would be up to them to decide if you’re a candidate for the Upper Cervical procedure, and whether or not you’ll benefit from the care. Not everyone can be helped though, as certain conditions are contraindicated. A consultation and exam, at the very least, could prove to be helpful.
Getting second and third opinions from multiple professionals isn’t a bad idea either. Talk with a cardiologist and/or a neurologist to see what they have to say about all of this as well. Cardiology and neurology forums are available here on MedHelp.
I hope this answer provides you some valuable information. Best of luck to you.
Warm wishes,
ART
Thanks for your question. An MRA is an imaging study that produces pictures of the body’s major blood vessels.
A pair of vertebral arteries travel down the sides of your neck. These vessels were analyzed during the MRA. The report is basically telling you that the left vertebral artery is noticeably thinner/smaller than the right one.
I cannot tell you that having one vertebral artery thinner than the other is going to induce suboccipital headaches. Due to the location of your headaches, I would suspect that the atlas, or C1 vertebra at the top of your neck is misaligned, and getting uncomfortably close to either the base of your skull (occiput) or to the posterior arch of axis, C2.
Rotation of the head, coupled with extension (looking up) is a bad recipe for anyone with significant arterial asymmetry of this nature. While chiropractic adjustments are extremely safe, due to the potential significance of a diminutive artery, I would recommend against manual rotational movements of the head/neck – regardless of which professional performs them (PT, DC, DO, or MD).
I would also recommend that you use caution when washing your hair. Many people extend their heads to rinse their hair, and this position could duplicate the movements your PT performed, and cause you to experience the “vasovagal pre-syncope” again.
You might consider consulting an Upper Cervical Chiropractor and share your MRA findings with him. But make sure the DC you choose is an exclusive Upper Cervical specialist (there are approximately 500 in the US). They’ll take unique x-ray views of your neck, and will be able to determine if an upper cervical misalignment is causing your headaches.
Ultimately, it would be up to them to decide if you’re a candidate for the Upper Cervical procedure, and whether or not you’ll benefit from the care. Not everyone can be helped though, as certain conditions are contraindicated. A consultation and exam, at the very least, could prove to be helpful.
Getting second and third opinions from multiple professionals isn’t a bad idea either. Talk with a cardiologist and/or a neurologist to see what they have to say about all of this as well. Cardiology and neurology forums are available here on MedHelp.
I hope this answer provides you some valuable information. Best of luck to you.
Warm wishes,
ART
