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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