Relationship between vertebral artery blood flow in different head positions and vertigo

Abstract

Objective: To identify the vertebral artery blood flow in different head positions in patients with positional vertigo with no specific diagnosis.

Methods: Patients with history of vestibular symptoms associated with changes in head position were enrolled into the study. Healthy volunteers were evaluated as control group. Doppler ultrasonography examination of the cervical segment of the vertebral arteries was performed under three different head positions: (i) supine position, (ii) head hyperextended and rotated to the right side and (iii) head hyperextended and rotated to the left side.

Results: In the study group, right and left vertebral artery blood flow was significantly lower in the ipsilateral hyperextended position compared to standard supine position (respectively p = .014; p = .001), but did not differ significantly when compared between the standard supine and contralateral hyperextended positions (respectively = .959; p = .669). In the control group, left and right vertebral artery blood flow did not differ significantly when the head was hyperextended to the right or left sides compared to standard supine position (p > .05).

Conclusions: Our data demonstrated that the etiology of vestibular complaints in patients with undiagnosed positional vertigo might be related to impairment in vertebral artery blood flow according to head positions.

Chinese abstract

目的：确定患位置性眩晕而无确诊的患者不同头位的椎动脉血液流量。

方法：与头部位置变化相关的前庭症状史患者被纳入研究。将健康志愿者作为对照组。在三个不同的头位进行椎动脉颈段的多普勒超声检查：（i）仰卧位, （ii）头部伸出并转向右侧, （iii）头部伸出并转向左侧。

结果：研究组的同侧超伸展位置的右侧和左侧椎动脉血流量显着低于正常仰卧位（分别为p = 0.014; p = 0.001）, 但标准差仰卧位和对侧超伸张位置之间并没有显著差别（分别为p = .959; p = .669）。在对照组中, 与标准仰卧位相比, 当头部向右侧或左侧伸张时, 左、右椎动脉血流量没有显着差异（p > 0.05）。

结论：我们的数据表明, 患未确诊位置性眩晕患者前庭不适的病因可能与不同头部位置的椎动脉血流量有关。

Keywords:

• Positional vertigo
• vertebral artery
• ultrasonography
• Doppler

Disclosure statement

The authors have no funding, financial relationships, or conflicts of interest to report.