Stroke

 A stroke means that the blood supply to a part of the brain is suddenly cut off. The brain cells need a constant supply of oxygen from the blood. Soon after the blood supply is cut off, the cells in the affected area of brain become damaged, or die. A stroke is sometimes called a ‘brain attack’.

The blood supply to the brain comes mainly from four arteries – the right and left carotid arteries, and the right and left vertebrobasilar arteries (see diagram below). These branch into many smaller arteries which supply blood to all areas of the brain. The area of brain affected, and the extent of the damage, depends on which blood vessel is affected.

For example, if you lose the blood supply from a main carotid artery, then a large area of your brain is affected which can cause severe symptoms, or death. On the other hand, if a small ‘branch’ artery is affected, then only a small area of brain is damaged which may cause relatively minor symptoms.

 

There are two main types of stroke – ischaemic and haemorrhagic.

Ischaemic stroke – occurs in about 7 in 10 cases

Ischaemic means a reduced blood and oxygen supply to a part of the body. This common form of stroke is usually caused by blood clot in an artery which blocks the flow of blood.

The blood clot often forms within the artery itself. This commonly occurs over a patch of fatty material called atheroma. (Atheroma is sometimes called ‘furring’ or ‘hardening’ of the arteries.) Small patches of atheroma form on the inside of arteries in most older people. If a patch of atheroma becomes thick, it can ‘trigger’ the blood to clot.

In some cases, the blood clot forms in another part of the body, and then travels in the bloodstream (this is called an embolus). The most common example is a blood clot which forms in a heart chamber as a result of abnormal turbulent blood flow. This may occur in a condition called atrial fibrillation (see separate leaflet). The blood clot is then carried in the bloodstream until it gets stuck in an artery in the brain.

There are other rare causes of ischaemic stroke.

Haemorrhagic (bleeding) stroke
A damaged or weakened artery may ‘burst’ and bleed:

An intracerebral haemorrhage is when the blood vessel bursts inside the brain. The blood then spills into the nearby brain tissue. This can cause the affected brain cells to lose their oxygen supply, and become damaged or die. This accounts for about 1 in 10 strokes.

A subarachnoid haemorrhage is when a blood vessel bursts in the subarachnoid space. This is the narrow space between the brain and the skull. This space is normally filled with a fluid called the cerebrospinal fluid. About 1 in 20 strokes are due to a subarachnoid haemorrhage.

The type and extent of disability caused by a stroke can vary greatly. It depends on the extent of the damage to the brain.

A large stroke can cause death. A small stroke may cause minor problems, which may go completely over time. In many cases, the effects are somewhere in between these two extremes.

The sort of problems that may occur include one or more of the following:

Weakness of one side of the body. This may cause problems with walking if a leg is affected, or problems using an arm or hand properly.

Problems with balance and co-ordination.

Swallowing problems are common. In some cases this can be dangerous as food may go down the windpipe rather than down the gullet when you eat. Because of this it is usual to do ‘swallow test’ on all people with a stroke before they are allowed to eat or drink. This is to make sure that swallowing is safe. If there is severe difficulty with swallowing then you may need to have food and drinks passed into your stomach via a tube.

Speech and communication difficulties. This may range from a difficulty in finding the correct words to say in the middle of a sentence, to being completely unable to speak. Also, understanding speech, reading, or writing may be affected.

Difficulty with vision. If a part of the brain that deals with vision is affected then problems may arise. For example, some people who have had a stroke have double vision, and some people lose half of their field of vision.

Difficulties with mental processes. For example, difficulty in learning, concentrating, remembering, etc.

Inappropriate emotions. For example, following a stroke, some people cry or laugh at times for no apparent reason.

Tiredness.
The treatment given by hospital are: physiotherapists, occupational  therapists, speech therapists, dieticians, psychologists, specialist nurses and doctors. The weakness of this treatments is none of them are root- targeted

Current medicine haven’t got successful treatment for post-stroke. Alternative health practitioners, however, believe they know some ways to help with the recovering.  It is clinically proved we are gaining a great success in this area.

Combing with western mobilization and modern technique originated from Japan which are based on the idea of helping the nervures self repairing and regenerating by stimulating the related area, our TCM skill can mediate the effects of this disease because it release endorphins and peptides in the brain, which modulate sensory information between the brain and body.

Chinese Herbal Medicine for Stroke

When prescribing Chinese herbal medicine for a patient that has suffered a stroke, great care is taken to differentiate the appropriate pattern of disharmony that has brought upon the incident. In acute cases, determining whether the stroke was physically caused by ischemia (obstruction of a vessel causing a lack of blood supply) or hemorrhagia (a burst vessel causing bleeding within the cranium) helps determine the course of treatment. While herbal treatment can be an effective form of therapy during the acute stage of a stroke, more often patients visit a Traditional Chinese Medicine (TCM) practitioner in the latter stages for treatment of lingering stroke symptoms. In these post-acute stages, opening the blood vessels and promoting the flow of blood are the primary goals when prescribing herbal treatments for stroke. Blood stasis often remains after the stroke, obstructing the meridians (energy pathways). Traditional formulas include Zheng Gan Xi Feng Tang (Control Liver Extinguish Wind Decoction) and Bu Yang Huan Wu Tang (Tonify Yang Give Back 50% Decoction), useful for hemiplegia, weakness, aphasia, and other sequelae of cardiovascular incidents.

For dementia patients who have suffered strokes, the Chinese herbal medicine called gastrodine (Tian Ma) compound granule has shown benefits and compare favorably with conventional treatments. In a randomized double-blind study, this medicine demonstrated effectiveness in improving impaired memory, orientation, language and other effects of stroke in patients who were diagnosed with mild to moderate vascular dementia (VaD) after a stroke.

Ren Shen Zai Zao Wan, or Ginseng restorative pills, stimulate blood circulation, tonify blood, yin, and energy, and dispel stagnation. It is used primarily for symptoms such as contractive or flaccid muscle tone in extremities, speech impediments, facial paralysis, and numbness and tingling in limbs. This remedy is best given immediately following a stroke, and is available in prepared form (pills).

Chinese herbs are not regulated, and may not be measured precisely, as is done in Western pharmacological medicine. Caution should be observed when considering their use, as there may be variations among formulations and batches. Always taking Chinese herbal medicine for stroke under the guidance of an experienced practitioner.

Acupuncture for Stroke

Acupuncture can be an effective complementary treatment to use alongside conventional Western medicine used for stroke recovery. Acupuncture can assist with nerve regeneration, decrease blood viscosity, stop the aggregation of blood cells, trigger the release of hormones that enlarges blood vessels, and assist surviving nerve cells with bypassing damaged parts of the brain and creating new pathways. Studies have demonstrated that acupuncture is effective in assisting with stroke recovery, especially for those with moderately severe damage. Acupuncture also may help treat hypertension, headaches and dizziness among those who have experienced a stroke. In addition, acupuncture combined with pushing manipulation on the fingers of stroke patients who have difficulty using their fingers leads to significantly improved finger flexion.

Several forms of acupuncture treatment are utilized in stroke recovery. Electro-acupuncture involves applying a pulsating electrical current to acupuncture needles to further stimulate the acupuncture points, which enhances the level of stimulation of the acupuncture points and can lead to greater improvements in muscle tone and restoration of mental faculties. Scalp acupuncture is another method of acupuncture treatment that is effective in post-stroke patients. Various studies have shown the benefits of this form of acupuncture therapy for hemiplegia and other neurological disorders. During scalp acupuncture, needles are inserted between the layers of skin on the scalp to stimulate local areas of the brain, and it primarily follows the modern medical understanding of neurological mappings of brain activity.

Acupuncture points used for stroke are focused on balancing the body based upon the differential diagnosis formed by the acupuncturist. Often the selected points include Gallbladder 20, Large Intestine 4, Du 20, Kidney 6 and Stomach 36. Acupuncture treatment should be given several times a week during the recovery stage to yield the best clinical results.

Combining Traditional Chinese Medicine (TCM) Herbs and Acupuncture

One of the benefits of Traditional Chinese Medicine (TCM) is the flexibility it offers patients. Acupuncture and Chinese herbal treatments can be used at the same time for even more effective relief. In cases of post-stroke depression, the combination of herbs with acupuncture can be just as effective as Western medical treatments.

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