Traumatic+brain+injury

Blockage of Qi

 * Symptoms:** Unresponsiveness, severe confusion, agitation, delirium, restlessness, flushed face, fever.
 * Tongue:** yellowish with sticky coat
 * Pulse:** rapid, deep
 * Herbal Treatment:** An Gong Niu Huang Wan; Zi Xiu Dan; Zi Bao Dan
 * Acupuncture Treatment:** stimulate points on the GV channel on head combined with points on limbs. slightly bleeding Jing-well points

Exhaustion of Qi

 * Symptoms:** Deep coma, loss of jaw control, lost bladder control. heavy perspiration, cooling distal limbs
 * Tongue:** whitish coat
 * Pulse:** weak
 * Herbal Treatment:** Shen Fu Tang + San Qi
 * Acupuncture Treatment:** moxibustion and/or retaining needles to points on the Ren channel adding stimulation at CV-4. CV-6, CV-8

**Prolonged comatose Status:**

 * Herbal Treatment:** An Gong Niu Huang Wan; Su He Xiang Wan
 * Acupuncture Treatment:** stimulate points on the GV channel on head combined with points on limbs. slightly bleeding Jing-well points

**Aphasia**

 * Herbal Treatment:** Ren Shen Zai Zao Wan
 * Acupuncture Treatment:** GV-15, CV-23, HT-5

**Paresis**
//Upper limb paralysis:// LI-15, LI-11, LI-10, TW-5, LI-4 //Lower limb paralysis:// GB-30, GB-34, ST-36, ST-41, BL-60 //Facial paralysis:// CV-17, St-4, St-6, GB-14, LI-4, SI-18, ST-7
 * Herbal Treatment:** Huo Luo Dan
 * Acupuncture Treatment:** GV-20, GV-16, BL-7 and the points of Yang channels of the affected side

Blood Stasis

 * Symptoms:** Migraine-like headache and cognitive deficiency
 * Tongue:** purple or purple spots
 * Pulse:** stringy, hesitant
 * Herbal Treatment:** Xue Fu Zhu Yu Tang; Shu Jing Huo Xie Tang
 * Acupuncture Treatment**: Korean Sa-Am protocol: Lung tonification - LU-9(+), SP-3(+), LI-11(-), TW-5(-)

Stasis Obstructing the orifices of the brain pattern

 * Symptoms:** After acute traumatic brain injury: unclear thinking, spirit mind haziness and clouding, unclear speech, vexation, agitation, headache, dizziness, dark facial complexion. Sx may be woorse at night.
 * Tongue:** dark, purplish
 * Pulse:** wiry, choppy or fine
 * Herbal Treatment:** Xue Fu Zhu Yu Tang; Shu Jing Huo Xie Tang
 * Acupuncture Treatment**: Korean Sa-Am protocol: Lung tonification - LU-9(+), SP-3(+), LI-11(-), TW-5(-)

Qi Deficiency and Blood Stagnation

 * Symptoms:** Fatigue, dull headache, low voices, lassitude, anorexia, palpitations, shortness of breath, aversion to cold, cool limbs
 * Tongue:** thin whitish coat
 * Pulse:** thready, weak
 * Herbal Treatment:** Bu Yang Huan Wu Tang, Yi Qi Hua Yu Tang, Tao Hong Si Wu Tang

Kidney Yin Insufficiency

 * Symptoms:** Dizziness, tinnitus, dry mouth, flushed cheeks, 5-palm heat
 * Kidney Symptoms:** Constant dull headache with a feeling of emptiness, lassitude, debility, aching and weakness of the lower back and legs, forgetfulness, decreased intelligence
 * Tongue:** reddened tongue with little coat
 * Pulse:** deep, weak
 * Herbal Treatment:** Liu Wei Di Huang Wan, Jin Gui Shen Qi Wan

Kidney Yang Insufficiency

 * Symptoms:** Aversion to cold, cold limbs, listlessness, impotence, nocturia, pale complexion, spontaneous perspiration
 * Kidney Symptoms:** Constant dull headache with a feeling of emptiness, lassitude, debility, aching and weakness of the lower back and legs, forgetfulness, decreased intelligence
 * Tongue:** pale and corpulent with thick whitish coat
 * Pulse:** weak
 * Herbal Treatment:** You Gui Wan, Shen Qi Wan

Liver Dysfunction

 * Symptoms:** Cramping Headache in temple and vertex aggravated by anger, faintness, giddiness, insomnia, bitterness in mouth, decreased self-control, irritability, restlessness, insomnia, tremors, twisting of the body, loaclized or generalized convulsions
 * Tongue:** thin yellow coat
 * Pulse:** stringy, rapid
 * Herbal Treatment:** Tian Ma Gou Teng Yin

Qi Deficiency

 * Symptoms:** Dull headache, aggravated by fatigue, lassitude, anorexia, palpitations, shortness of breath
 * Tongue:** thin white coat
 * Pulse:** thready, weak
 * Herbal Treatment:** Bu Zhong Yi Qi Tang

Blood Deficiency

 * Symptoms:** Headache, dizziness, palpitations, insomnia, dreamful sleep, blurred vision, numbness of the limbs
 * Tongue:** pale
 * Pulse:** thready
 * Herbal Treatment:** Si Wu Tang

Both Qi & Blood Deficiency
Dull headache, aggravated by fatigue, lassitude, anorexia, palpitations, shortness of breath, headache, dizziness, palpitations, insomnia, dreamful sleep, blurred vision, numbness of the limbs
 * Symptoms:**
 * Tongue:** pale/thin white coat
 * Pulse:** thready, weak
 * Herbal Treatment:** Ren Shen Yang Yi Wan; Shi Quan Da Bu Wan

Kidney Yin Deficiency

 * Symptoms:** Lumbago, lassitude, dizziness, tinnitus, nocturnal emission, premature ejaculation, dry mouth, sore throat, flushed cheeks, 5-palm heat
 * Tongue:** reddened tongue with little or no coat
 * Pulse:** thready, rapid
 * Herbal Treatment:** Qi Ju Di Huang Wan

Liver Yang Hyperactivity

 * Symptoms:** cramping headache over temple and vertex, intermittent dizziness, giddiness, restlessness, irritability, insomnia, bitter tasteat
 * Tongue:** N/A
 * Pulse:** taut, wiry
 * Herbal Treatment:** Liu Wei Di Huang Wan + Zhen Gan Xi Feng Wan

Disturbed/Stagnant Liver Qi Overacting on Spleen/Stomach

 * Symptoms:** Nausea, anorexia, abdominal distention, acid regurgitation, loose stool, irregular menstruation
 * Tongue:** N/A
 * Pulse:** wiry
 * Herbal Treatment:** Long Dan Xie Gan Wan

Liver Qi Deficiency

 * Symptoms:** Pallor of the face and lips, lassitude, tinnitus, deafness, liability to panic
 * Tongue:** N/A
 * Pulse:** taut, wiry
 * Herbal Treatment:** Dan Zhi Xiao Yao Wan

**Scalp Acupuncture**
Main Points: Ant. oblique line of Vertex-Temporal (MS6), Posterior oblique line of Vertex-Temporal (MS7) or the motor area Match with the usage area for apraxia, balance area, GV-16 & 15 both for disturbance of consciousness //[from A Practical Handbook on Scalp Acupuncture, Jin Shi-Ying, Jin Wan Cheng]//:

//Brain:// M-1 (basal ganglion), M-2 (cranial nerves & cerebrum), M-3 (Cerebellum); Ypsilon points: BL, ST Basic Point A: cerebral disturbances, vertigo, headaches, migraine
 * Yamamoto New Scalp Acupuncture**

**Point Selection for Chronic Post-TBI Headache**
//**Occipital:**// GB-20, BL-10, BL-60 - Distal Bladder Channel Points //**Frontal:**// ST-8, GV-24, GV-25, LI-4, ST-44 - Distal Stomach Channel Points //**Temporal:**// GB-8, TW-5, GB-41 - Distal Gallbladder Channel Points //**Parietal/Vertex:**// GV-20, SI-3, BL-67, LR-3 - Distal Liver Channel Points

**Blood Stasis:**
Korean Sa-Am protocol: Lung tonification - LU-9(+), SP-3(+), LI-11(-), TW-5(-) //Source: The Practice of Sa-Am Acupuncture//

**Auricular Acupuncture:**
//Source: Auriculotherapy Manual by Terry Oleson// //Primary:// Brain, Brainstem, Master Cerebral, Forehead, Occiput, Adrenal Gland C., Lesser Occipital Nerve, Point Zero, Shen Men, Thalamus Point, Heart C., Kidney C.
 * Concussion:**

//Primary:// Brainstem, Forehead, Occiput, Lesser Occipital Nerve, Point Zero, Shen Men, Kidney C., Thalamus Point, Master Cerebral, Heart C.
 * Encephalitis, Brain trauma**

Hypothalamus, Amygdala, Hippocampus, Master Cerebral, Point Zero, Shen Men [Helms, J.M. et al., HMI Auricular Trauma Protocol: An Acupuncture Approach for Trauma Spectrum Symptoms, //Medical Acupuncture//, 23(4) 209-213, 2011.]
 * HMI Auricular Trauma Protocol**



**Korean Hand Acupuncture:**
1) Kidney Jung Bang 2) Spleen Sung Bang 3) Liver Jung Bang, Stomach Jung Bang 4) Symptomatic Treatment Points: A8, A12, A16, A18, A28, B19, B22, B24, C7, E39, I2, I19, I38
 * Cerebral Thrombosis:**

1) Heart Sung Bang 2) Kidney Jung Bang 3) Lung Jung Bang 4) Symptomatic Treatment Points: A8, A12, A16, A18, B19, B24, D7, E8, G7, I2, I14, I38, K6
 * Cerebral Hyperemia:**

1) Lung Jung Bang 2) Large Intestine Sung Bang 3) Liver Sung Bang 4) Symptomatic Treatment Points: A8, A12, A16, A33, B19, B24, B26, D2, E8, E38, I2, I14, I19, I38, K6 //[Source: Koryo Hand Acupuncture Vol. 1 By Tae-Woo Yoo]//
 * Habitual Headache:**

**Kiiko Matsumoto's Headache protocols:**
//Sources: Kiiko Matsumoto"s Clinical Strategies Vol. 1 & 2//

Oketsu (AKA Blood Stasis, "Bad Blood" or Toxic Blood)
//Front:// Left Lr 4 inserted at exact location that relieves P/P on left Ki15/ST 27 area (by aprox. 50-80%). Usually needled w/flow 15-45 degrees medial to the tendon. Japanese Lu5- exact location that reduces oketsu area best. If a hard lump is present (Oketsu Kai) needle left ST 27 (with rapid pulse). Good for releasing tightness in the face, sinus and occipital region. If abdomen is cold, Kyutoshin is recommended. If pulse is slow, Bilateral S.I. shu points, HJ of T2-T6. Pick the most gummie points and needle 45 degree toward the spine. Stimulate every 5 min. //Back:// BL 17, BL18 ( 45 degree with flow) or the HJ's( 45 degree toward spine) needled bilaterally if tightness or P/P is found.If right BL 17 is higher and more contracted/painful than the left, needle BL 35 on the left at the exact angle that releases P/P on right BL 17/18 area. Use a 50 mm needle w/ Kyutoshin if area is cold.
 * Clinical Manifestations:**
 * Chronic digestive problems such as; stomach ulcers, acid stomach, chronic appendicitis and constipation.
 * Arteriosclerosis, high BP, Stroke (pre/post)
 * GYN problems
 * Back pain, sciatica
 * Rashes, eczema and skin problems
 * Depression, anxiety and neurosis
 * Urinary tract problems
 * Bronchitis, asthma, emphysema and tuberculosis
 * Palpatory Findings/Reflex Areas:**
 * Hardness in the triangle area between KI 15 and ST27, Oketsu Kai is a palpable lump in the area. If present, prognosis is longer and local treatment required.
 * Yin meridians of the leg should be palpates 2" distal to the groin. Vascular compression of the inner thigh may be a contributing factor to Oketsu.
 * Pressure or pain in the right occipital area. Right-sided occipital headache or migraine may be an indication of Oketsu.
 * Pulse Findings:** ST 27 for Oketsu Kai with rapid pulse. Do not needle abdomen with slow pulse.
 * Treatment:**

Stagnation of Blood in the Head
//Front :// (1) Bilateral Sp9 needled at 10 degree angle. Bilateral Sp6 at a 45 degree angle. Both with the flow of the meridian. (2) Bilateral PC choice and Lu5. Treatments on left and right arms do not have to be symmetrical. If Pc6 is needled, 45 degree with the flow of meridian. Lu5 is needled at a 15-45 degree angle with flow. This should change p/p at the top of the head. Needles left in for 15 minutes. //Back:// (if pt presents with p/p along the cervical spine or Huato Jiaji along the cervical spine. TX is the same as Vertebral Artery Insufficiency.) Bilateral Ki 10 and Lr 8 inserted @ a 45-90 degree angle. TW5 or 9 inserted perpendicularly. Micro-stimulate the needles once every 5 min. Retain needles for 15 min. Then Bilateral I-HI-Kon. Bl 58 and 40 insert shallowlly at a 15-45 degree angle with flow. Slight in/out stim. BL 40 is slightly lateral to TCM location. BL 60 needle upwards/against flow with short in/out thrusts for 30 seconds.8-15 direct thread size moxa may be required if skin is loose.
 * Clinical Manifestations:**
 * Forgetfulness, confusion, lack of concentration, speech disorder
 * Headaches, nausea, vomiting, eyesight problems, difficulty walking
 * Insomnia, fatigue,
 * Low blood pressure
 * Chronic sinus problems
 * Numbness/tingling of the limbs
 * Heavy feeling at the occipital area
 * Palpatory Findings/Reflex Areas:**
 * the area of GV 20, Sishencong, UB channel near GV 20. Skin should feel loose and not tightly stretched over the bone. May be painful upon palpation. There may also be a gelatin filled space between the skull and scalp.
 * Pressure/Pain at the base of the skull. " The pressure pain is an indication of vertebral and basilary artery insufficiency whicj is one of the leading causes of stagnation of blood in the head. __NOTE__: Oketsu, immune, adrenal, ST Qi and vertebral artery treatments are usually administered in the first 20 minutes.
 * Pulse Findings:** TW5 is indicated for a rapid pulse TW9 for slow pulse.
 * Treatment:**

Common associated symptoms following a brain injury: Tinnitus Dizziness/vertigo Insomnia Headache Nausea Fatigue Epilepsy/Seizures and here Bipolar syndrome/mania and withdrawal Hemiplegia/Atrophy Syndrome PTSD Irritability/Emotional Lability Impaired memory / memory enhancement Ophthamologic conditions