Cerebral thrombosis is also recognized as atherosclerotic and
thrombotic cerebral infarction and is caused by the pathological
changes of cerebral arterial wall together with elevation of
blood coagulation, leading to vascular narrowness, obstruction
and ischemic changes of the corresponding cerebral tissue, which
may be followed by necrosis. This disease, in TCM, is included
in the category of "zhong feng" (apoplexy).
Main Points of Diagnosis
1. The disease is more common in middle-aged and old people.
There may be transient numbness of limbs, fatigue and aphasia
before the onset of the disease.
2. The attack often occurs in sleep, when the blood pressure is
lower and blood flow is slower. A few cases may be seen after
strenuous exercise.
3. Neural manifestations include central monoplegia and
hemiplegia. They may be accompanied with aphasia, but are often
with hemihypoesthesia and hemianopia. There may also be
disphagia and disturbance of consciousness. Unilateral optic
atrophy and Horner's syndrome may be present.
4. Cerebrospinal fluid examination shows no change in pressure
and cell content. This can be used to distinguish cerebral
thrombosis form cerebral hemorrhage. CT scanning is helpful in
the determination of location and extent of cerebral necrosis.
Differentiation and Treatment of Common Syndromes
Main Symptoms and Signs: Slow onset, attacks occurring mostly in
rest or sleep, full consciousness, deviation of the eye and
mouth, aphasia, hemiplegia, dark purple tongue with thin and
white fur, thready and weak pulse.
Therapeutic Principle: Supplementing qi and nourishing blood,
promoting blood circulation to remove obstruction in the
channels.
Recipe: Modified Decoction Invigorating Yang for Recuperation.
astragalus root
cinnamon twig
peach kernel
safflower
Chinese angelica
ligusticum rhizome
red peony root
earthworm
red sage root
achyranthes root
All the above herbs are to be decocted in water for oral
administration.
Apart from the above recipe, supplementary ingredients should be
employed: 6 grams of ground beetle should be administered for
case with severe blood stasis; 15 grams of codonopsis root for
those with extreme deficiency of qi; 6 grams of prepared aconite
root for those with dominative cold; 10 grams of pinellia tuber
and 10 grams of tabasheer for those with profuse sputum; 10
grams of grassleaved sweetflag rhizome and 10 grams of polygala
root for those with aphasia. If the patient's blood pressure is
normal, astragalus root can be dosed as much as 60 grams or even
more; and if the patient has hypertension, the dosage of
astragalus root should be decreased in accordance with practical
conditions. To treat the case with deviation of eye and mouth,
10 grams of batryticated silkworm, 6 grams of giant typhonium
tuber and 6 grams of scorpion should be administered; to treat
constipation, 10 grams of hemp seed administered; to treat those
whose major symptom is paralyses of lower extremities, the
ingredients for nourishing the liver and kidney are to be
included, such as 15 grams of loranthus mulberry mistletoe, 15
grams of prepared rehmannia root and 15 grams of fleece-flower
root.
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