what are some causes of Stroke?
Thrombosis, hemorrhage - interrrupts the blood supply which results in the ischemia of brain tissue
What are some symptoms of stroke?
- Slurred speech
- Blurry vision
- Paralysis of one side of the face
- Loss of conscious
- coma
- Sudden onset
What are the 3 stages of Stroke?
Acute - 2 weeks, no more than 1 month ( western medicine)
Recovering - 2 weeks to 6 months (acupuncture)
Sequelae - (>6 months)
What is the differences between a ischemia (TIA) and hemorrhage?
Ischemia (TIA)
Due to Thombosis
Build up, block flow to an area, lack blood supply
Hemorrhagic
Broken blood vessels
Small artery, aneurism, weak blood vessels can cause either a cerebal hemorrhage or subarchnoid hemorrhage
Whats the pathology of Stroke? tcm
- Xu - Yin Xu, Qi and Blood Xu
- Fire - Lu Fire, heart fire, phlegm fire, Liv fire
- Qi - Qi Sinking, reverse flow of qi
- Blood - Stasis
- Wind - Lv Wind, external wind
- Phlegm - Wind Phlegm, damp phlegm
Differentiate between sites of attacks?
meridians vs ZF
Meridians - Mild: block channel and collaterals fail to nourish (dev of mouth, slurred speech)
Zang Fu - Severe ( yang rising + fire + wind block orifices: coma/loss of consciousness) *main sign would appear as mental confusion
Which meridians would we use to treat?
Primary: Yang Ming meridian + Du meridian
Secondary: Taiyang and Shaoyang
When should you treat Ischemic stroke?
As early as you can
When it is recommend you treat hemorrhagic stroke
Wait for 2 weeks for treatment or till blood pressure drops
What types of modalities should we use?
Scalp acupuncture Electroacupuncture Auricular Plum Blossom Cupping
What points would you use for them?
Scalp: Sensory line, leg and sensory line, tremor line, speech 2/3line
Face Edema - Blood vessel contract/dilation line
Dizziness - Healing line
EA: Low Freq (2-4Hz), intermittent wave 20-30 mins, 2-3 pairs
Auricular : kidney, brain, shenmen, subcortex, heart, liver + affected areas
Plum blossom - huatuojiaji, yangming+shaoyang meridian - moderate tapping
Cupping - T2-T8, L1-L5, UB line
How would you education the patient?
- Try to prevent and treatment patients with hypertension (do not ask them to get off heart medication)
- Regular exercise/prevent obesity
- balance lifestyle, regulate stress - be active
- regulate emotions
- regulate diet - (low salt, cholesterol and fat, high in fruits and vegetables, and more lean meats and beans), no alcohol, smoking, or greasy fatty foods
- regulate bowel movements - at least 1x a day, release toxins
- treat underlying disease - diabetes, heart disease
- high risk patiens - use herbs to prevent ( at risk: yin def with yang rising patients) or moxa - moxa ST 36, GB 31 and 39 for best results
prevention is key
What are the 5 degrees of Stroke?
I - Slight finger movement ii - Finger movement with slight movement of forearm/arms iii - Resistant and weight of hand iv - Between 3 and 5 v - normal movement of hand
What is the difference between a tense and flaccid?
tense: no bowel movement or urination
Fists clench
Flaccid: mouth open,
open so loss of bowel and urine
what is the etiology of stroke?
Upper - excess Liver Yang rising
lower - Def - Kid/Liv Yin def
Patterns in the acute stage
Attack by wind
uprising of wind yang
Patterns in acute state - attack on the Z-F organs
Tense syndrome - Yang and Yim
Flaccid Syndrome
Stroke: Patterns during the recovery stage
Hemiplegia
- Qi Xu with blood stasis
- Liver and Kidney Xu
Aphasia
- Wind phelgm blocking collaterals
- kidney essences xu
What is stroke?
Impairment of one or more vessels in the cerebral circulation
