This paper was presentated at
THE 5th WCA (WFAS2000), ON SEOUL KOREA
on Nov.13, 2000.


ACUPUNCTURE TREATMENT FOR A CEREBRAL HEMORRHAGE CASE STARTED IMMEDIATELY AFTER ATTACK




Hitoshi Kato and Naoko Onodera
The Taisei Acupuncture Clinic
10-23, Akita city, 010-0871, Japan.*

1. Introduction

We have treated a cerebral hemorrhage case almost only by acupuncture. This paper describes a method and significant effect of acupuncture treatment started 10 minutes after attack.

---------- Right after the attack ----------


[CT-1]--------------------[CT-2]--------------------[CT-3]

---------- After acupuncture treatment ----------


[CT-4]--------------------[CT-5]--------------------[CT-6]


[CT-1] to [CT-3] were taken on the 8.5 hours after the attack. [CT-4] to [CT-6] were taken on the 19 days after the attack.

2. The Patient's information

The General Information is as follows;

Female
65 years old
Housewife

She had been treated in our acupuncture clinic from 5 years ago as follows;
The chief complains were

(1) Headache
(2) Sleeplessness
(3) Perspiration at head and face
(4) Face suffusion
(5) Coldness of the legs and feet

The blood pressure was 110 to 70 and there are not any problems on the Western medicine.
We diagnosed as deficiency of Kidney-yin, so we had treated to reinforce Kidney-yin by acupuncture once on every 10days. The 40 days before the attack, she had not received our treatment.



3. Method

3-1 The Attack and Emergency Acupuncture Treatment

The attack occurred at 2:00 a.m. on Dec. 25th, 1999, and we visited the patient at once.
We had treated as following table within 10 minutes after the attack. Then, she was transferred to a Research Institute for Brain and Blood Vessels immediately.

CHART

3-2. The diagnosis by the specialists for cerebrovascular accidents

(i) CT

[CT-1] to [CT-3] were taken on the 8.5 hours after the attack.

(ii) Diagnosis

The patient was diagnosed by the specialists as
(1) serious hemiplegia at the right side
(2)dyslalia
(3)aphagia
caused by cerebral hemorrhage at the left side of the thalamus.
They also estimated as
(a) Never recovered
(b) She must need a wheelchair.

(iii) The policy for treatment

The specialists and we decided following procedure;
(a) Course-observation at the ICU until the symptom becomes stable
(b) After that, physical therapy should be started
(c) Our acupuncture treatment is also continued to apply

3-3 Treatment

The following graph shows the blood pressure and the pulse.

At first, it is the most important thing to minimize the hemorrhage through stabilizing the blood pressure and the pulse. And then, it is important to promote absorption of the extravasated blood.
In order to achieve this, it was very important to reinforce Taixi (KI-3) of the right side. Purging hyperactivity of the Liver-yang, and flaring up of the Heart-fire at Xingjian (LR-2) was also applied. Furthermore Blood letting at Shixuan (X-UE-11) was added at the 5.5 hours after the attack, and it was very effective.
It is clear that the blood pressure and the pulse are stabilized after our acupuncture treatment. According to this effect, acupuncture treatment should be started as soon as possible after attack.

GRAPH

Our acupuncture treatment is shown as in the following table.

TABLE

According to the condition, we have needled with appropriate needling sensation, especially for Taixi (KI-3) of the right side. By this, she began to recover. Before this treatment, there were clouding of consciousness, disturbance of speaks, and hemiplegia at the right side, but after our needling, we brought some significant effects. For example, the sensitivity and the ability of movement were recovered rapidly right after the appropriate needling sensation. Then, the specialists decided to give her some foods. She was encouraged at these effects and her QOL improved substantially.

4. Result

[CT-4] to [CT-6] show the extravasated blood is absorbed by the 19 days after the attack. As a result, complete ADL (no palsy) has been achieved.


5. Discussion

5-1. Emergency acupuncture treatment

"Guidelines on basic training and safety in acupuncture" (WHO 1999) says that acupuncture is contraindication as emergency treatment. However, we considered that certain cases including cerebrovascular accident should be treated by acupuncture as soon as possible. This makes QOL of patients higher.

5-2. The mechanism for this case. (From the viewpoint of TCM)

Cerebral hemorrhage has tended to be considered as caused by wind. However, in this case, we have not diagnosed as caused by wind. Because, any symptoms of wind, such as aversion to wind-cold, unfixed diseased location, etc. were not find out. Our consideration is as follows;

TABLE

Serious deficiency of Kidney-yin.

Hyperactivity of Liver-yang , Flaring up of Heart-fire It tends to rise into the upper-left side of the human body.

Excess in the upper part and deficiency in the lower Maldistribution of the Qi and the blood ( upper > lower, left > right )

Cerebral hemorrhage at the left side

TABLE

5-3 Our acupuncture treatment

By MRI, the absorption of the extravasated blood began to appear from the 10 days after the attack. Only our acupuncture treatment has been applied, except the administration of depressor for the 10 hours, so we consider it is a significant effect of acupuncture treatment. However, in any steps, it is important to treat according to the pattern identification for TCM. We are convinced; this improves QOL of patients.

6. Conclusion

Acupuncture treatment is known as a treatment for aftertrouble of cerebrovascular accidents. This case further infers that acupuncture must be very important as a main treatment and as an emergency treatment for cerebrovascular accidents.

7. Key words

emergency acupuncture treatment , cerebral hemorrhage


* NOTES;
Our add. was changed on Jun,2001.
Our new add. is as follows;

Name; Hitoshi Kato and Naoko Onodera.
Institute; The Taisei Clinic of Acupuncture.
Add.; 13-3, Akita-city, 010-0811, Japan.
Tel/Fax +81-18-868-1131
E-Mail; tcm_acu@hotmail.com



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