The vertebral artery (VA) is a major artery in the neck. There are two vertebral arteries located on either side of the neck which branch from the subclavian arteries. The VA ascends and enters the cranium through the foramen magnum where it unites with the opposite vertebral artery to form the basilar artery (at the lower border of the pons).
The vertebral artery test is used to test the vertebral artery blood flow and observe for any possible symptoms of vertebral artery disease (also known as vertebrobasilar ischaemia (VBI)). The test involves the patient lying supine while the PT performs, first a passive extension, followed by a passive rotation of the neck in both directions.
This maneuver causes a reduction of the lumen at the third division of the vertebral artery, resulting in decreased blood flow of the intracranial VA of the contralateral side. It causes ischemia due to blood loss in the pons and the medulla oblongata of the brain. This results in dizziness, nausea, syncope, dysarthria, dysphagia, disturbances of hearing or vision and paresis or paralysis of patients with VBI.
A reduction of blood flow may result in a transient ischemic attack (TIA) – which is a precursor of stroke. The test therefore provides an opportunity to prevent permanent disability or even death because of its ability to quickly and correctly predict TIA if the test is positive.
An appropriate response if a positive VA test is observed within the clinical/hospital setting is to quickly notify the patient’s physician and if observed elsewhere outside the clinical setting, is to send the patient to the hospital, where s/he can be further examined.
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