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Vertebrobasilar Insufficiency Exacerbation in the Context of an Active COVID-19 Infection
Abstract
Background: Vertebrobasilar insufficiency (VBI) is caused by impaired blood flow in the posterior cerebral circulation. Coronavirus disease 2019 (COVID-19) has been associated with endothelial dysfunction and vascular inflammation that may exacerbate underlying cerebrovascular disease.
Case Presentation: A 57-year-old male with hypertension and type 2 diabetes mellitus presented with acute worsening of chronic vertigo, nausea, and vomiting. Computed tomography angiography demonstrated stenosis of the basilar, left vertebral, and left internal carotid arteries, while magnetic resonance imaging excluded an acute cerebrovascular accident. The patient tested positive for SARS-CoV-2 and was treated symptomatically with dual antiplatelet therapy. His symptoms improved, but he left the hospital against medical advice before completing treatment.
Conclusion: This case suggests a potential association between acute COVID-19 infection and exacerbation of vertebrobasilar insufficiency in patients with underlying cerebrovascular atherosclerosis. Further studies are needed to clarify this relationship.
Author(s): Lexi May1, Maeve Brown1, Seseragi Yasumaru1, Leonard Ranasinghe2*, Nalin Ranasinghe3
1M3 Student, California Northstate University College of Medicine, USA
2Professor of Emergency Medicine, M4 Co-Director, and Co-Director of Research, California Northstate University College of Medicine, USA
3Assistant Clinical Professor, California Northstate University College of Medicine, USA
Corresponding Author: Leonard Ranasinghe
Address: Professor of Emergency Medicine, M4 Co-Director, and Co-director of Research Director, California Northstate University College of Medicine, Elk Grove, California 95757, USA.
Received date: 27 May 2026; Accepted date: 29 June 2026; Published date: 11 July 2026
Citation: May L, Brown M, Yasumaru S, Ranasinghe L, Ranasinghe N. Vertebrobasilar Insufficiency Exacerbation in the Context of an Active COVID-19 Infection. Asp Biomed Clin Case Rep. 2026 Jul 11;9(2):130-34.
Copyright © 2026 May L, Brown M, Yasumaru S, Ranasinghe L, Ranasinghe N. This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium provided the original work is properly cited.
Keywords: Vertebrobasilar Insufficiency, COVID-19, Vertigo, Cerebrovascular Disease, Posterior Circulation Ischemia
Abstract
Background: Vertebrobasilar insufficiency (VBI) is caused by impaired blood flow in the posterior cerebral circulation. Coronavirus disease 2019 (COVID-19) has been associated with endothelial dysfunction and vascular inflammation that may exacerbate underlying cerebrovascular disease.
Case Presentation: A 57-year-old male with hypertension and type 2 diabetes mellitus presented with acute worsening of chronic vertigo, nausea, and vomiting. Computed tomography angiography demonstrated stenosis of the basilar, left vertebral, and left internal carotid arteries, while magnetic resonance imaging excluded an acute cerebrovascular accident. The patient tested positive for SARS-CoV-2 and was treated symptomatically with dual antiplatelet therapy. His symptoms improved, but he left the hospital against medical advice before completing treatment.
Conclusion: This case suggests a potential association between acute COVID-19 infection and exacerbation of vertebrobasilar insufficiency in patients with underlying cerebrovascular atherosclerosis. Further studies are needed to clarify this relationship.