Stroke

Stroke – either deficiency (open) or excess (closed) patterns
Excess – happens during an activity, usually involves bleeding and high blood pressure or blood vessels disorders or brain tumor or trauma (close observation for 48 hours post trauma)
Deficiency – attack occurs during quiet time, involves blockage with blood stasis, embolisms or fat and phlegm stasis or trauma(close observation for 48 hours post trauma)
Post trauma pre stroke symptoms – nausea, vomit, headache, blurred vision (brain edema)

Symptoms of Ischemia

Blockage Hemorrhagic – Bleeding
Headache Slight or none Severe
Nausea/Vomiting Possible Severe
Stiff Neck Possible Always
Coma/Loss of Mental Capacity Slight, short period of time Occurs quickly lasting 30-60 min
Paralysis One part of body Ratio – ie left face, right arm
Striking Time During restful period Occurs during activity
Constipation Possible Often

Stroke will always involve either Interior or Exterior Wind. If there is wind and phlegm it will give rise to Epilepsy – Ban Xia Bai Zhu Tian Mai Tang

Wind and Yang – dizziness, stomach/Large intestine (Liver and Kidney Yin deficiency with either Yang or Fire)
Wind and Fire – with phlegm, connects to heart with headache (Liver and Kidney Yin deficiency with either Yang or Fire)
Wind either attacks the organ or the meridian:
Organ – Yang – more closed pattern – wind, fire, phlegm
Formulas for Yang Closed Pattern: Heat Phlgm, Phlegm Fire
An Gong Niu Huang Wan
Zi Xue Dan
Zhi Bao Dan
Yin – open pattern, more dangerous – yin and yang collapse
Si Ni Jia Ren Shen Tang Qi Fu Tang
Shen Fu Tang Mai Dong, Wu Wei Zi
Sheng Mai San
Yin Closed Pattern: Cold Phlegm – Su He Xiang Wan
Meridian – Collaterals – Lou – Local area effected
– Meridians – Jing – usually half the body, ie – half arm

Must Read: Dang Gui Liu Huang Tang – nourish Yin, clears Heat, stabilize exterior, stop night sweating

Acupuncture Pre-Stroke

closed pattern-Pc 9, Pc 8, Du 20,Du 26, Lv 3, KD 1, Ren 22, St 40, Ren 12

open pattern –Moxa Du 20-Ren 4-Ren 6-Ren 8, Pc 6, Du 25

Acupuncture Post Stroke:
Use points on the Yang Meridians (more Qi and Blood)
Use Du meridian Pts – governs all yang meridians and directly goes inside brain

Prevention of Stroke:

1900’s – Ren Shen, \Ban Xia, Bai Zhu, Chen Pi, Dang Gui, Sheng Jiang, Huang Qi, Niu Xi, Zhu Li, Mai Dong, Shu Di Huang
Now – Dang Gui, Bai Shao, Gou Teng, Fu Ling, Gan Cao, Ban Xia, Niu Xi, Sheng Di Huang, Shi Chang Pu, Di Long, Huang Qi
Stroke – Kidney and Liver Yin deficiency = high blood pressure
(Liu Wei Di Huang Wan, Tian Wang Bu Xin Dan)
– Clear Phlegm – easily mixed with Fire = Hemorrhage stroke
(Wen Dan Tang, Dao Tang Tang, Di Tan Tang, An Gong Niu Huang Wan, Tian Ma Gou Teng Yin)
– Blood Stasis – easily mixed with Qi deficiency = blockage stroke
(Bu Yang Huang Wu Tang, Si Wu Tang)
Disturbance of Consciousness:
Somnolence, Stupor, Confusion, Coma (1,2,3), Syncope

Treatment Methods For Stroke:

Kai Qiao – open orifices
Xi Feng/Qian yang – calm mind
Zhi Bu Gan Shen – tonify liver and kidney
Que Tan/Huo Xue – move phlegm and promote blood circulation

Signs of Menningeal Irritation:

Patient Symptoms: Headache, anxious, irritability, skin sensitivity, photophobia, sensitive hearing, nausea, vomiting
Other Symptoms: stiff neck tension, vomiting, fever, disturbed consciousness, spasm, involuntary movement
TCM – Head – connects to Stomach, Large Intestine and Bladder (Tai Yang, Yang Ming)
Brain – connects to Kidney, Heart (Shao Yin, Jue Yin)
Shao Yang – ? – can be either connect to Head or Brain!