Intrinsic stenosing and occlusive pathologies of the vertebral artery: A narrative review

Abstract

Intrinsic pathologies of the vertebral arteries, such as atherosclerosis, dissection, fibromuscular dysplasia, radionecrosis and vasculitis, are important causes of vertebrobasilar insufficiency and cerebrovascular events. This review focuses on non-aneurysmal intrinsic stenosing and occlusive pathologies, covering their epidemiology, diagnosis, and treatment options. It also provides a detailed summary of key clinical presentations and syndromes, including an in-depth examination of lateral medullary syndrome, historically known as Wallenberg's syndrome, which is arguably the most emblematic condition resulting from vertebral artery involvement and is depicted in an illustrative cartoon.

Keywords: Atherosclerosis; Dissection; Fibromuscular dysplasia; Lateral medullary syndrome; Radionecrosis; Stroke; Transient ischemic attack; Vasculitis; Vertebral artery; Vertebrobasilar; Wallenberg's syndrome.