Rotational artery dizziness — your information sheet
When sustained head turning briefly reduces blood flow to the back of the brain
What's going on
Two blood vessels — the vertebral arteries — run up the back of the neck and supply blood to the brainstem. In a small number of people, one of these arteries can be briefly pinched when the head is turned to a particular side for several seconds. This can produce a sudden 'unwell' feeling, brief double vision, or a sense of being about to fall, which clears as soon as the head returns to the middle.
This is uncommon but important to recognise because it is treatable — and because it is the one form of neck-related dizziness that, untreated, can occasionally cause a stroke. The treatment plan focuses on avoiding the position that triggers your symptoms, controlling vascular risk factors, and in some cases surgical decompression.
Most people who follow the plan do well. The key is treating this condition specifically and not mixing it up with the gentler manual treatments that suit other forms of neck dizziness.
What helps
- Knowing your trigger position and avoiding sustained head turns into it. If your trigger is right rotation, get into the habit of turning your whole body to look right instead of just your head.
- Reversing in the car using mirrors and the reversing camera — not the over-shoulder turn.
- Tight blood-pressure control. Targets agreed with your GP.
- If you smoke — stopping. Smoking damages the blood vessel walls and makes the condition worse.
- Cholesterol-lowering medication if your levels are raised — your GP will advise.
- Aspirin or a similar anti-platelet medication if your doctor has prescribed one.
- Follow-up vascular imaging as advised — to monitor the artery.
What to avoid
- Forceful neck manipulation ('clicking' or 'cracking' of the neck) — strictly avoid. This can be dangerous in your condition.
- Yoga poses, exercises, or stretches that involve sustained head turning. Discuss with your instructor.
- Habituation exercises (repeated provocation to 'desensitise' to symptoms) — appropriate for some kinds of dizziness, but not yours.
- Holding the head in your trigger position for any prolonged time (e.g. painting overhead, hairdresser's basin, prolonged shoulder-check posture).
When to seek further help
- URGENT — phone your local emergency number (e.g. 999/112/911) if symptoms last more than a few minutes after returning the head to neutral, or if you develop weakness, slurred speech, drooping face, or sudden severe headache.
- Worsening of your usual pattern — symptoms triggered at smaller angles, more frequent, lasting longer.
- New symptoms appearing between episodes (continuous unsteadiness, vision changes, memory problems).
- A fall during an episode, even if you recover quickly.