Ultrasound analysis of the relationship between the variation of vertebral artery running and the onset of vertigo

Objective To analyze the relationship between the anatomical variation of intervertebral segment of vertebral artery(the artery do not get into skull via C-6 transverse foramen) and the onset of vertigo. Methods Fifty-four patients with vertigo were selected as vertigo group, and 56 healthy person without history of cardiocerebrovascular diseases and vertigo were selected as control group.The types of variation of the intervertebral segment of vertebral artery and the peak systolic velocity (PSV) were detected by color Doppler flow imaging (CDFI), and the PVS of intracranial segment of the vertebral artery was detected by TCD. The effect of running variation on the PVS of intracranial and extravertebral arteries and their relationship with the onset of vertigo were analyzed. Results The incidences of the variation of vertebral artery running in the vertigo and control groups were 83% (45/54)and 21.4% (12/56), respectively (P=0.001). There were 57 patients with variation of vertebral artery running altogether in both groups, and the patients with bilateral variation were more likely to develop vertigo than those with unilateral variation(P=0.021); There was no statistical significance between the high(higher than C3) or low position of variations of the vertebral artery running and the incidence of vertigo(P=1.000). The PSVs of intervertebral segment of vertebral artery and intracranial segment in patients with running variation were 56±10 and 53±10 cm/s respectively, and in patients with normal vertebral artery running were 59±12 and 56±11cm/s, respectively. There were statistical differences between the PSVs of intervertebral and intracranial segments in patients with running variation and normal vertebral artery(P=0.047 and 0.041, respectively); and the PSV in patients with running variation in intracranial segment of vertebral artery was lower than that in intervertebral segment, and there were significant differences between them(P=0.038). Conclusion The combined detection with CDFI with TCD can objectively analyze the variation of the vertebral artery running, and this variation may be the cause leading to vertigo.