Vertebrobasilar insufficiency of blood supply (VBI) is a common disease in the elderly, and now there is a trend of gradual rejuvenation. Clinical manifestations: vertigo, accounting for more than 80% of the cases, is often the first symptom, and can be a sense of rotation, swaying, shaking, tilting, often accompanied by nausea, vomiting, unstable standing, and even dare not open their eyes, and need to lie down. Severe cases may be accompanied by blackness, double vision, facial numbness, unfavorable speech, weakness of one or both limbs, tinnitus or even tilting attacks, and a few may have syncope. The seizures can last for several minutes, or up to several hours. The seizures can occur several times a day, and in some patients they can occur for several days. Signs: Nystagmus, commonly horizontal nystagmus, rarely rotational, vertical. Very rarely, facial or limb hyperalgesia and mild limb immobility are seen. Pathogenesis: Mainly hemodynamic changes, a few due to microemboli. (1) With age, arteriosclerosis worsens, the arterial lumen narrows, and blood flow gradually decreases. (2) Degeneration of the cervical spine, narrowing of the vertebral space and formation of bone redundancy, resulting in compression of the vertebral artery, which affects blood flow when the neck is sharply moved. (3) There are more variants of the vertebral artery, and some people have congenital stenosis or even single-branch ischemia. Examination items: lateral cervical spine film or cervical spine CT, brain CT or MRI, cervical vascular ultrasound, blood lipids, blood sugar, etc. Treatment measures: (1) Active treatment of diseases related to atherosclerosis, such as hypertension, hyperlipidemia, diabetes, etc. In the acute period of insufficient blood supply, the blood pressure of hypertensive people should not be too low, not less than 30% of the prevailing blood pressure. (2) Develop good living habits, quit smoking and drinking, eat lightly, live a regular life, and participate in more outdoor activities. (3) During the attack period, bed rest is required, oral vasodilators such as nimodipine can be taken, and a doctor should be seen at the hospital as soon as possible. (4) For those who have recurrent attacks or have a tendency to cerebral thrombosis, if the effect of drug intervention is not effective in the case of clear vascular stenosis, you can follow the doctor’s advice and place a vascular stent.