Case study-scalp acupuncture candidate

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Case study-scalp acupuncture candidate:

Patient is a 43 yo male. Seven days ago, he suffered a hemorrhagic

stroke. Symptoms began with waking at about 3 am with left arm

numbness. Patient then describes a gradual progression of symptoms

that involved loss of motor control of the left arm and leg as well

as the left side of the face. The patient was admitted to the

hospital at about 6 am with completely loss of motor control on the

left side of his body. Scans showed a fist sized blood clot in the

right frontal parietal region of the cortex. Surgery was preformed

and the clot was removed. There apparently was no sign of aneurysm or

tumors. Frozen sections of the clot were negative for the presence of

malignant cells. In other words, the underlying cause of the

hemorrhaging is unknown to his neurosurgeon or neurologist. They

speculate that he may have had a congenital abnormality of some small

vessels in this part of his brain. The patient recovered well from

the surgery but was left with total flaccid paralysis of the left

side of his body. The effects seem to be strictly motor. Five days

later, the patient is able to move his right lag and walk with

assistance. The left arm is still completely paralyzed and left side

of face drooping. The patient is able to speak and communicate. His

cognition appears unaffected.

 

Before this incident, the patient was extremely fit and active. He

does not have a history of hypertension or other conditions that

would predispose one to stroke from a western perspective. His has

begun aggressive physical rehabilitation in the hospital and is to be

moved to a rehabilitation hospital for further therapy. He would seem

to be a good candidate for scalp acupuncture. My question regards the

use of scalp acupuncture in a patient who has recently undergone a

surgery of this magnitude. I have not seen the surgeon's report but

the incision line can be clearly seen and extends in a straight line

from roughly UB6 to GB6 on the right. What concerns me is what lies

below the incision line. As far as I know, in a procedure such as

this, the scalp would be retracted in both directions perpendicular

to the incision line and a section of the skull temporarily removed

to allow visualization and access to the affected area of the brain.

As far as I know, after the surgeon is done with his work on the

brain itself, the section of skull is replaced by drilling small

holes around the perimeter of the section of bone that was removed,

and corresponding holes around the perimeter of the area where the

piece of skull will now be replaced. Sutures or screws would then be

used to secure the section of skull back to its original position.

Therefore, my concern is that these areas are directly below the

areas used in scalp acupuncture (motor area, etc). At the very least,

it seems that there would be a significant amount of scar tissue in

that area of the scalp.

 

Obviously, I would need to learn more of the details of exactly what

was done during surgery and what " hardware " may have been used below

the scalp surface. The scalp incision itself was closed with surgical

staples, which will be removed shortly.

 

Is there anyone out there who has had experience treating a patient

with scalp acupuncture who has had a surgical procedure that was

preformed in the same basic areas that would be needled?

 

As a side note, the mortality rate is significantly higher in

hemorhagic stoke compared to ischemic strokes. Luckily for this

patient, the bleed occurred in the outer portion of the brain and not

more to the interior and the pressure on the brain was successfully

reduced. On the plus side, those patients that survive a hemorhagic

stroke generally have better recoveries than those who suffer from

ischemic strokes.

 

Any comments will be appreciated.

Jack Gorfien MS, L.Ac.