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CEREBROVASCULAR ACCIDENTS

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Updated: Wednesday, Mar 11,2009, 1:55:17 PM
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Stroke REVIEW
       Stroke, or stroke, is a neurological disorder caused by a focal
pathological process in a blood vessel. In most cases the onset is sudden and evolution
fast, and the symptoms reach a peak within seconds, minutes or hours. Partial or
May complete recovery occur over a period of hours to several months.
       Occlusion of an artery by cerebral thrombosis or cerebral embolism resulting in a
infarction with its clinical effects. Other conditions in May on the occasion also to produce and therefore the stroke May be confused with a thrombosis or a cerebral embolism. These include cerebral venous thrombosis, cerebral arteritis, systemic
hypotension, reactions to cerebral angiography, and transient cerebral ischemia.
       Cerebral hemorrhage is usually caused by the rupture of a cerebral vessel atherosclerosis. Subarachnoid hemorrhage is usually due to rupture of a congenital weakness of the blood vessels or aneurysms.
       Transient cerebral ischemia in May also occur without producing a stroke. Premonitory recurrent focal cerebral ischemic attacks occurred in May and are likely to be in a repetitive pattern in a given case. Attacks last May to 10 seconds to 1 hour, but the average is 2 to 10 minutes. As several hundred of these attacks occur in May In some cases, transient ischemia, the neurological deficit in May last 20 hours.
       Extra narrowing of the arteries (especially the internal carotid artery at its origin in the neck and in some cases, the intrathoracic arteries) arteriosclerotic patch has been charged in a significant number of cases of transient cerebral ischemia and of infarction.
       In traditional Chinese medicine, disease is considered to be caused by wind stirring from the hyperactivity of Yang in the liver, resulting from frustration or agitation accompanied by a disruption of the Zang-fu organs Qi and blood imbalance of Yin and Yang and the malfunctioning of the channels and collaterals. Another factor is endogenous wind caused by heat-phlegm after over-indulgence of alcohol and fatty food.
CLINICAL MANIFESTATIONS
       Early phase. Varying degrees and types occur. Violent early May, with
the patient falling to the ground and lying inert as a person of deep sleep, with
flushed face, stertorous breathing or Cheyne-time, full and slow pulse, and an arm and legs usually flaccid. Death May occur in a few hours or days. Small notes
stroke in May consisting of slight derangement of speech, thought, movement, sensation,
or vision. Consciousness should not be changed. Symptoms May last seconds to minutes
or greater or May persist unabated for an indefinite period. A degree of
recovery is usual.
       May premonitory symptoms are headaches, dizziness, drowsiness, and mental
confusion. Focal premonitory symptoms are more likely to occur with thrombosis.
       Generalized neurological signs are more common with cerebral hemorrhage and
include fever, headache, vomiting, convulsions and coma. Stiff neck are common
with subarachnoid hemorrhage or intracerebral hemorrhage. Mental generally noted changes in the period following a stroke in May and include confusion, disorientation and memory defects.
DIAGNOSIS
       Essentials of diagnosis.
       ? Sudden onset of focal neurological complaints ranging from motor and speech defects hypesthesia or deep coma.
       ? May be associated with vomiting, seizures or headaches.
       ? Stiff neck often.
TREATMENT
I. Treatment Western medicine.
       1. Acute onset or
       A. General measures.
       The patient needs to complete bed rest and handled carefully to avoid
injury. Give tranquilizers or sedatives necessary to control agitation.
       B. anticoagulant therapy.
       Maintenance on the anticoagulant treatment was recommended for the treatment and prevention of cerebral thrombosis or insufficiency of the carotid or vertebral-basilar system. The evidence is more promising for transient cerebral ischemia. The risk of bleeding, especially in patients with hypertension, is high.
       C. Antiplatelet agents.
       Several studies have shown that aspirin May reduce the risk of stroke and ischemic stroke, particularly among men. Aspirin 0.3/per days.
       D. Surgery. Narrowing of the artery extra, as shown on angiography May
be an indication for surgical correction.
       2. The problems in hemiplegic patients
       A. The protection of the upper extremity paralysis.
       In most cases, no useful function returns to the paralyzed upper extremity. With
unknown to the hand, the patient should spend the paralysis of the fingers, wrist and elbow
through the full range of motion twice a day. Treatment of shoulder pain is
analgesics, immobilization, and gentle range of motion exercises.
       B. The treatment of aphasia.
       If aphasia occurs, the speech must be started as soon as possible. If
secondary or receptive aphasia is present, the above program in May rendered extremely difficult because it is based on the patient's ability to understand
direction.
       C. Hemianopia care.
       If hemianopia is present, the patient should be trained to turn the head to the hemianopic side in order to save the visual field to the view.
       D. Care sphincters.
       Hemiplegic Some are incontinent in the first phase. The patient should be
reminded voluntarily empty the bladder at intervals of one hour. These intervals can be gradually increased.
       E. organic brain syndrome.
       Impaired work is an obstacle to the rehabilitation program. Confusion
May be present at the same time and in the absence, at another, and should take advantage of
patient lucid period. Organic brain syndrome occurs more often in patients who have had several strokes. The patient's mental status improves during rehabilitation.
       F. drugs.
       All central nervous system depressant, medication, even in small doses, have a May
adverse effect on the stroke patient.
May they cause or exacerbate confusion
aphasia, lack of balance and incontinence. When used as anticonvulsant or hypotensive
agents, they should be replaced if possible by nondepressant drugs. On the other
hand, the central nervous system stimulants may help improve function in the patient confused and depressed.
II. Treatment in traditional Chinese medicine.
2. Prophylactic measures
       Senile patients with deficiency of Qi and excessive sputum or events of the hyperactivity of Liver Yang such as dizziness and palpitations May sometimes have symptoms of stiffness of the tongue, slurred speech and numbness of the fingers. There are signs of prodromal windstroke. By focusing on prophylactic measures are nutrition and daily activities, avoiding over-tension. Frequent moxibustion on B39 and S36 Zusanli May Xuanzhong prevent attacks.
     3. Acupuncture therapy
       Acupuncture therapy is an essential stage of recovery and convalescence.
       There are two types of windstroke depending on the degree of severity: the severity and mild type type.
       The severe type. In this type, the Zang-fu organs are attacked and symptoms occur in the channels, collaterals and viscerae. The severe type can be further divided into two subtypes:
       A. Tension syndrome. The main events of this type are sudden collapse, coma, eyes, clenched fists and jaw, redness of the face and ears, the gurgling of sputum, coarse breathing, retention of urine, and the constipation, nervous and energetic momentum rolling. The limitation of the hole is:
       Key points: Renzhong GV26, GV20 Baihui Yongquan and K1.
       Auxiliary points: Jiache $ 6, $ 7 and Xiaguan LI4 Hegu to tighten the clamps; CV22
Tiantu and S40 Fenglong of gurgling with sputum; GV15 Yamen, L7 Lieque Tongli for H5 and aphasia and the rigidity of the language.
       Method: All major points are used with the auxiliary
points according to symptoms and the puncture is moderate. The needles are
kept for 15 minutes and treatment is administered once a day.
       B. Syndrome flaccid. Demonstrations are coma, relaxed hands, agape
mouth, eyes closed, pallor, profuse sweating drops on the head and face, and snoring.
May it also be incontinence of feces and urine, cold and members of the weak pulse. The
requirement of the perforation is:
       Points: LI11 Quchi, CV4 Guanyuan Shanque and CV8.
       Method: All the above are perforated moderate stimulation. The
needles are retained for 20 minutes and treatment is administered once a day.
       The mild type. In this type, only the channels and collaterals are attacked and symptoms relate only to the channels and collaterals. Symptoms and signs
are mainly those of the serious nature, involving canals and
collateral. There are also cases without primary affliction of Zang-fu organs.
Demonstrations are hemiplegia or deviation from the mouth to cause motor or sensory impairment.
       For hemiplegia. This May be severe or mild and the attack in May on
on each side of the body. Initially, the affected Member May be soft and later
they become stiff, which ultimately leads to disability. May there be dizzy
and dysphasia.
       Key points: Baihui GV20, GV16 Fengfu and B7 Tongtian.
       Auxiliary points: LI15 Jianyu, llll Quchi, TE5 Waiguan and LI4 Hegu for
upper extremities; G30 Huantiao, G24 Yanglingquan and $ 36 for the lowest Zusanli
ends.
       Method: All major points are used with the auxiliary
points according to symptoms. The needles are retained for 20 minutes and
treatment is administered once a day.
       1. Herb therapy
       A. When the patient complained of disorientation, cough with rales, coma, chest distress, with shiny white coating of the tongue and slippery pulse, the formula is given.
       Dao Tan Tang Jia Jian.
       Constituents:
       Dried orange peel old 12g
       Pinellia 10g
       Tuckahoe 10g
       Licorice root 6g
       Jack-in-the-pulpit 10g
       Ciron immature fruit or trifoliate orange 10g
       Fritillary bulb 10g
       Tabasheer 10g
       Racine violet flower Peucedanum 15g
       Apricot kernel 12g
       Root of the narrow-leaved Polygala 12g
       Grass-leaved sweetflag 12g
       Decoction and dosage. All herbs over a dose and six to ten doses are prescribed with a daily dose. Each dose is cooked twice and then the broth of each joint, half the broth mixture each time, twice a day.
       B. When the patient has a muscle wasting and weakness of lower limbs with reduced mobility of the joints of the knees and ankles, which are caused by blood vessels empty, malnutrition of the muscles of the lower limbs, sensory disorders of the skin, the formula is prescribed.
       Bu Yang Huan Wu Tang Jia Jian.
       Constituents:
       Milk veteh 40g
       Chinese angelica 30g
       Not peeled root of herbaceous peony 30g
       Chuanxiong 20g
       Earth-worm 15g
       Peach kernel 12g
        Safflower 12g
        Cassia 12g
        Ox-knee 15g
        Scorpion 10 pcs
        Root of red-rooted Salcia 30g
        Licorice root 6g
        Decoction and dosage is the same.
        In addition, injections prepared from the root of red rooted salvia and chanxiong are also very effective. 40cc red-rooted salvia injection of 250 and 500cc more than 10% glucose can be administered intravenously once a day and a course lasts two weeks. Chuanxiong injection may be administered only intramuscularly, 80mg each time, or 500cc 4% glucose, once a day intravenously. 
1.Purslane-Dietary Therapy 
2.Focus on addressing the root causes 
3.The integration of life with nature 
      

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