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The vertebral and basilar arteries supply blood to several structures in the brain including: the occipital cortex, the brainstem consisting of the midbrain, pons and medulla, the cerebellum and the thalamus. Atherosclerosis or hardening of the arteries is the primary cause of vertebrobasilar disease. The narrowing of the vertebral or basilar arteries caused by atherosclerosis creates vertebrobasilar insufficiency (VBI), or an insufficient delivery of blood flow to the posterior structures of the brain.
The medulla is supplied by the posterior inferior cerebellar artery and by direct smaller branches from the vertebral arteries. The pons is supplied by small and large branches from the basilar artery. The midbrain and thalamus are supplied by penetrating arteries from the posterior cerebral arteries.