Vertebral Artery Test

Published July 2, 2026 Read time 2 min read Readers 1

What is the "Vertebral Artery Test" used for?

Vertebral Artery Test or De Klyn Test is used in the assessment of vertebral, basilar, or carotid artery stenosis or compression.

This test requires certain preliminary findings as it is not entirely without risk. Parameters requiring prior assessment include blood pressure, arm pulse, and pulses in the common carotid and subclavian arteries with auscultation to detect any murmurs or bruits.
This test should not be performed if any of these prior examinations produces significantly abnormal findings. In the absence of any significant abnormalities, the seated patient is asked to maximally rotate his or her head to one side while extending the neck.
The test can also be performed with the patient supine, in which case the patient’s head projects over the edge of the examining table and rests in the examiner’s hands. Then with the head hanging down (in the De Klyn position), the head is maximally rotated and the neck extended. The head should remain or be held in maximum rotation and extension for about 20 to 30 seconds. The patient is then requested to count out loud.

Abnormal auscultatory findings in the common carotid artery, vertigo, visual symptoms, nausea, fatigue, or nystagmus occurring during this maximum rotation and extension indicate stenosis of the vertebral artery or common carotid artery.
The test is especially important in candidates for treatment (such as traction or manipulative therapy) of cervical spine symptoms associated with vertigo.
The vertebral artery provocation test aids in the differential diagnosis because nausea, vertigo, and nystagmus initially increase but then rapidly decrease in intensity when a vertebral blockade is present.
In the presence of vertebral artery insufficiency, the intensity of nausea and vertigo symptoms will rapidly increase within a few seconds without abating