Posterior Brain Circulation and Its Importance Regarding Hearing and Balance

Cerebral circulation is typically divided into anterior and posterior. The posterior cerebral circulation is supplied by the vertebrobasilar (VB) system which later connects with the anterior circulation via the posterior communicating arteries towards the circle of Willis [1]. This system serves as a critical arterial supply to the cervical spinal cord, brainstem, cerebellum, occipital lobes, and inner ear; therefore, understanding the anatomy and clinical significance of the VB system is critical when evaluating patients with posterior neurological síndromes, vertigo and hearing loss.

Posterior brain ischemia represents approximately 20% of all cerebral infarctions and dizziness is one of its most common manifestations [2]. Early diagnosis and treatment of ischemic events in the posterior circulation can save lives, prevent long-term disability and reduce healthcare costs, however, this remains more difficult to do than with other types of strokes [3].

This chapter aims to address the general anatomy of the posterior circulation and the importance of balance and hearing assessment when evaluating a patient with a possible ischemic event in this region.