Vertebral artery hypoplasia vs symptoms of vertebrobasilar insufficiency in the perimenopausal period

Symptoms of vertebrobasilar insufficiency are associated with disorders of the menopausal period. Among factors predisposing to insufficient circulation in the vertebrobasilar system are anatomical anomalies of the vessels, including diameter side-to-side asymmetry, particularly hypoplasia of the vertebral artery. The aim of the work was to assess the frequency of vertebral hypoplasia in consecutive age intervals in symptomatic women, in whom disorders of the labyrinth and lesions in the cerebello-pontine angle have been excluded. The results of 950 ultrasonography examinations (634 female and 316 male patients) were analysed. 4 definitions of hypoplasia were used: three morphological (the diameter of the narrower artery £2 mm, at least twofold difference between diameters of the arteries, and either of the conditions) and one functional (the flow volume ratio of the narrower artery £10%). The relative frequency of symptomatic patients in the perimenopausal period (51-60 years) was higher compared to other age intervals. The frequency of vertebral hypoplasia was higher in the 6th decade, depending on definition 4 (5.3%) as compared to 2 (3.7%) in the remaining group (for morphological definitions statistically significant difference by a=0.1). The results show that vertebral hypoplasia may exacerbate disorders associated with the perimenopausal period. Hypoplasia should be diagnosed by ultrasonography, since as a non-modifiable condition it can hinder the effects of hormone replacement therapy.