Cervical Arterial Dysfunction (CAD) Assessment (Vertebrobasilar Insufficiency (VBI) Test, Vertebral Artery Test (VAT), Neck Extension-Rotation Test)
What it measures:
The goal of cervical arterial dysfunction (CAD) testing is to evaluate the integrity of blood supply to the brain. This summary will address both the vertebral artery and the internal carotid artery, as compromise to either artery could be catastrophic (Kerry & Taylor, 2006; Kerry et al, 2008; Thanvi et al, 2005).
This summary contains information on use of this test in patients for whom cervical mobilization or manipulation is considered as an intervention; this includes clients with cervicogenic headaches and neck pain. Assessment of the blood supply to the brain is commonly thought to be important in order to avoid adverse effects such as cerebrovascular accident (estimated to occur in 1 in 400,000 cervical manipulations), dissection of the vertebral artery (estimated to occur in 1 in 5,000,000 therapy sessions) (Hutting et al, 2013; Rivett et al, 2006). Since neck pain and headache are the primary early symptoms of dissection of either the vertebral artery or internal carotid artery (Kerry et al, 2008; Rushton et al, 2015; Thanvi et al, 2005), compromise of these arteries is a particular concern when evaluating patients with these symptoms.
Australian Physiotherapy Association Clinical Guidelines for Assessing Vertebrobasilar Insufficiency (Rivett, 2006)
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