From the Research
Yes, right vertebral artery occlusion can cause left sensory symptoms. This occurs because the vertebral arteries supply blood to the brainstem and posterior portions of the brain, including structures that carry sensory information from one side of the body to the opposite side of the brain. When the right vertebral artery becomes occluded, it can affect areas like the medulla, where sensory pathways cross from one side to the other. Specifically, the spinothalamic tract, which carries pain and temperature sensation, crosses at the level of the spinal cord, while the dorsal column-medial lemniscus pathway, which carries vibration and proprioception, crosses in the medulla. Additionally, the vertebral arteries join to form the basilar artery, which supplies the pons and midbrain, where other sensory pathways cross. Therefore, ischemia from a right vertebral occlusion can damage these crossing pathways, resulting in sensory deficits on the left side of the body. This clinical presentation is part of various posterior circulation syndromes, such as lateral medullary (Wallenberg) syndrome, which typically presents with ipsilateral facial and contralateral body sensory deficits 1.
Some key points to consider in the management of vertebral artery occlusion include:
- The importance of prompt diagnosis and treatment to prevent further ischemic damage and improve outcomes 2
- The use of imaging studies such as angiography and magnetic resonance imaging to visualize the posterior circulation and identify areas of ischemia 3
- The potential for surgical intervention, such as recanalization of the occluded vessel, to improve morbidity and mortality 2
- The need for careful consideration of the risks and benefits of anticoagulation therapy in patients with vertebral artery dissection 4
In terms of the evidence, the most recent and highest quality study is from 2017 1, which highlights the importance of anatomical variation in the vertebral arteries and the potential for abnormal patterns of sensory-motor deficiencies in stroke. This study supports the idea that right vertebral artery occlusion can cause left sensory symptoms due to the crossing of sensory pathways in the brainstem. Overall, the evidence suggests that right vertebral artery occlusion can cause left sensory symptoms, and prompt diagnosis and treatment are essential to improve outcomes.