B: Stroke Flashcards
Western Cause of Stroke
thrombosis, embolism, stenosis or hemorrhage interrupting the blood supply to brain (Ischemia of brain tissue)
In Chinese they call it “Hit by Wind” (because it’s fast)
Stoke
Etiology and Pathology:
Causes?
Emotional frustration Yin Xu Constitution Elderly and Poor lifestyle Improper Diet Liver Excess Constitution Zheng Qi Xu and Xie Qi invasion
Onset of stroke - sudden or slow?
Sudden
Sx of Stroke?
sudden paralysis, slurred speech, impaired brain fx
3 stages of Stroke?
Acute
Recovery
Sequelae (long lasting Sx)
Where are the two places that a stroke can hit (in TCM)?
Meridians
Zang-Fu
What is the length of time for the acute stage of a stroke?
2 weeks to 1 month
What is the length of time for recovery stage of a stroke?
2 weeks to 6 months
How long do the sequelae of a stroke last?
often last a lifetime, and have stabilized after about 6 months
At which stages does acupuncture help?
Recovery and Sequelae - western medicine is best for the acute stage
Hemiplegia and Deviation of the mouth are a sign that the stroke is in which TCM location?
Meridians
Falling down in a fit, or sudden loss of consciousness are a sign that a stroke is in which TCM location?
Zang-Fu
What are the two types of Western strokes?
Ischemic
Hemorrhagic
What are the two types of TCM ACUTE STROKE that can happen as an attack on the meridians and collaterals?
Attack by wind, Uprising of Wind Yang
What are the three types of TCM ACUTE STROKE that attack the Zang-Fu?
Tense Syndrome- Yin or Yang
Flaccid Syndrome
What are the 5 types of ACUTE STROKE in terms of TCM?
Attack by WIND UPrising of WIND YANG YANG Tense Syndrome YIN Tense Syndrome FLACCID Syndrome
Numbness of the limbs, sudden deviation of the mouth, slurring of speech, drooling or hemiplegia, chills, fever, stiffness of the body, joint aches. Thin white coating on a normal tongue, floating rapid and weak pulse.
Dx?
Attack By WIND (Meridians and Collaterals) type of Stroke, Acute stage
Sudden deviation of the mouth, slurring of the speech, heaviness of the body or hemiplegia, headache, dizziness, blurred vision, tinnitus, insomnia or dream disturbed sleep. Red tongue with greasy coating, wiry, thready and rapid or wiry and slippery pulse.
Dx?
Uprising of Wind Yang (Meridians and Collaterals) - Acute Stage Stroke
Sudden loss of consciousness, tightly closed hands and clenched jaws, rigidity of the body, constipation, retention of urine. Flushed face, coarse breathing, halitosis, irritability. Yellow and greasy coating, wiry, slippery and rapid pulse.
Dx?
Yang Tense Syndrome type Acute Stage Stroke (Zang-Fu)
Sudden loss of consciousness, tightly closed hands and clenched jaw, rigidity of the body, constipation, retention of urine. Pale and dark face, listlessness, sleepiness, cold limbs, rattling in the throat. White and greasy tongue coating, deep, slippery and moderate pulse.
Dx?
Acute Stroke - Yang Tense Syndrome (Attack on Zang-Fu)
Sudden loss of consciousness with mouth agape and eyes closed, snoring but feeble breathing, flaccid paralysis of the limbs, incontinence of stool and urine. Profuse sweating, flaccid tongue, thready and weak or fading pulse.
Dx?
Acute Stroke - Flaccid Syndrome - Attack on the Zhang-Fu
What is the Chief Pathology for Stroke? (TCM)
Liver-Kidney-Yin Xu=> Yang Rising=> Wind Flares Up
What are the six TCM things that can mix together to cause stroke? Not all six are needed - 2 or three will sometimes do it…..
Xu (yin/ Qi+Bl) Fire (Liv/Ht/Ph) Qi (Sinking/Reverse) Blood (Stasis) Wind (LIVER/External) Phlegm (Wind-Ph/Damp-Ph)
What is the root/branch doing with Stroke?
Root = Xu Branch = Shi
What are the types of Recovery Stage Stroke? (2 weeks -6 months)
Hemiplegia - Qi Xu with Blood Stasis
Hemiplegia - Liver and Kidney Xu
Aphasia - Wind Phlegm Blocking Collaterals
Aphasia - Kidney Essence Xu
What are the two main over-types of Recovery Stage Stroke? (2 weeks to 6 months)?
Hemiplegia
Aphasia
What are the two types of Hemiplegia (recovery stage) Stroke?
Qi Xu with Blood Stasis
Liver and Kidney Xu
What are the two TCM types of Aphasia (Recovery Stage of Stroke)?
Wind-Phlegm Blocking Collaterals
Kidney Essence Xu
Flaccid Limbs, numbness of limbs, aphasia, drooling, deviation of the mouth, sallow complexion, frequent urination, incontinence of urine. Pale and purple tongue with white coating. Thready choppy or weak pulse.
Dx?
Recovery Stage of Stroke - Hemiplegia - Qi Xu with Blood Stasis
Flaccid limbs, numbness of limbs, aphasia, dizziness, tinnitus, restlessness, insomnia, flushed face, red lips. Deep red tongue with little coating. Wiry , thready, rapid pulse.
Dx?
Recovery Stage Stroke- Hemiplegia - Liver and Kidney Xu
aphasia, drooling, numbness of limbs, sticky, greasy coating on a shortened and rigid tongue, wiry and slippery pulse.
Dx?
Recovery stage Stroke - Hemiplegia - Liver and Kidney Xu
Aphasia, drooling, numbness of limbs, sticky and greasy coating on a shortened and rigid tongue, wiry and slippery pulse.
Dx?
Recovery Stage Stroke - Aphasia - Wind Phlegm Blocking Collaterals
Aphasia, soreness and weakness of lumbar and knee, hemiplegia, palpitations, SOB, pale thin and flaccid tongue with little coating, thin and weak pulse.
Dx?
Recovery Stage Stroke - Aphasia - Kidney Essence Xu
Types of Stroke - both acute and recovery stage?
Attack By Wind - Meridians and Collaterals –Acute
Uprising of Wind Yang - Meridians and Collaterals–Acute
Yang Tense Syndrome - Attack on the Zang-Fu–Acute
Yin Tense Syndrome - Attack on the Zang-Fu–Acute
Flaccid Syndrome - Attack on the Zang-Fu–Acute
Qi Xu with Blood Stasis - Hemiplegia —Recovery
Liver and Kidney Xu - Hemiplegia —Recovery
Wind Phlegm Blocking Collaterals - Aphasia—Recovery
Kidney Essence Xu - Aphasia—Recovery
Types of Aphasia (recovery) Stroke?
Wind Phlegm Blocking Collaterals
Kidney Essence Xu
Four major types of stroke (both recovery and acute)?
Attack on the Meridian and Collaterals
Attack on the Zhang-Fu
Hemiplegia
Aphasia
Main points for Attack on the Meridians and Collaterals, plus for Hemiplegia types of Stroke?
LI 4, 11, 15 GB 30, 34 ST 36, 42 SJ 5 UB 60
Main Points for Tense Syndrome type Stroke (yin or yang)?
All 12 Jing Wells
Du 26, Liver 3, Pc 8, St 40
Main Tx for Aphasia type of Recovery Stage Stroke?
Ren 23, Ht 5 (for slurring of speech)
Specific Points for Aphasia type stroke Wind Phlegm Blocking Collaterals?
Jinjin & Yuye
plus of course Ren 23 and Ht 5 Aphasia Points
Specific Pts for Aphasia type Stroke Kidney Essence Xu (Recovery stage) ?
UB 23, 52
K 3
(plus of course Ren 23 and Ht 5 Aphasia Points)
Education for Stroke?
Prevent and Tx High Blood Pressure
Decrease obesity
balance exercise and relaxation
regulate emotions
regulate diet (^fruits, veggies, beans, Decrease fat, salt, cholesterol, spice)
Keep bowels regular - decreases fire, and straining can increase pressure in head
Tx original Dz
Use herbals and moxa for prevention if high risk (moxa at GB 39, 31, St 36)
Main difference between Yang Tense Syndrome and Yin Tense Syndrome (both of which are Acute Stage Stroke)?
Yang: Flushed face, coarse breathing, halitosis, irritability, yellow (greasy) tongue coating.
Yin: Pale and dark face, listlessness, sleepiness, cold limbs, rattling in the throat, white (greasy) tongue coating
Total types of Stroke (TCM, Acute and Recovery)
ACUTE: Meridians/Collaterals: Attack by Wind, Uprising of Wind Yang Zang-Fu: Yin/Yang Tense Syndrome, Flaccid Syndrome
RECOVERY:
Hemiplegia:
Qi Xu with Blood Stasis
Liver-Kidney Xu
Aphasia:
Wind Phlegm Blocking Collaterals, Kidney Essence Xu
Basic Pts for Attack on the Meridians and Collaterals (Acute) and Hemiplegia?
LI 4, 11, 15 / GB 30, 34 / SJ 5 / St 36, 42 / UB 60
Basic Pts for Tense Syndrome (Attack on Zang- Fu)(ACUTE)?
All Jing Well Pts, Liv 3, PC 8, Du 26, St 40
Basic Points for Flaccid Syndrome? (Zang-Fu) (Acute)
Ren 4, 6, 8
Basic Points for Aphasia?
Ren 23, Ht 5
Points for Wind Phlegm Blocking Collaterals?
Basic Aphasia Pts Ren 23, Ht 5,
+ JinJin and Yuye
Kidney Essence Xu type Aphasia?
UB 23, 52 / K 3
+ Aphasia Basics Ren 23 / Ht 5
