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Stroke : Diagnosis
   
Western Medicine Chinese Medicine
When a stroke or an impending stroke is suspected, your medical adviser will want to know of any relevant family history such as whether you or any close relatives have suffered or died from strokes, high blood pressure, diabetes and/or have had problems with high cholesterol or other blood fats. Your medical adviser will also need to know whether you smoke tobacco, and what medications you are taking, including any non-prescription, homoeopathic or TCM medications. For example, some medications such as the oral contraceptive pill may increase your risks of stroke.

When doing a physical examination your medical adviser will measure your blood pressure, check your carotid arteries and other pulses for signs of blockage by fatty deposits (atheromatous plaques). They will also listen to your heart and lungs for signs of heart problems likely to cause stroke. A full neurological examination during which all the twelve cranial nerves (twelve nerves going directly from the brainstem to the face and upper body) are tested by checking the eyes, ears, facial muscles and feeling, ability to swallow and poke out the tongue will be done. Other tests of brain function such as memory tests, tests of muscle group strength, co-ordination, walking, speech and ability to feel hot, cold, vibration and a pin prick will also be performed during the physical examination.
Blood tests will be done to look for any blood clotting problems, high blood fats/cholesterol and any signs of diabetes. If you are considered at risk of having a stroke, an ultrasound of your carotid arteries may be performed to measure the level of any blockage in that artery.
An ultrasound of the heart may also be done to see if you are developing clots on the heart walls or in the major blood vessels leading from the heart to the brain.
The test most able to determine whether a stroke has already occurred is a computerized tomography scan (CT Scan) or a Magnetic Resonance Imaging (MRI scan). Both forms of scanning give a clear picture of the internal structure of the brain and can reveal where a blockage or a hemorrhage has caused brain damage.



 

Diagnosis in TCM is based on four examination techniques. The first is "questioning." The TCM practitioner will want to know what the individual's current complaints are, and will need their medical history and family health history. The second technique is "observation." Physical features of the body such as the face, tongue, hair, nails, sputum (mucus that is coughed up), and examining the area of pain all offer clues as to what the problem may be. Observation of the tongue is particularly useful as a gage to assess illness. The third technique is "hearing and smelling." Smelling the sputum and breath and listening to the sounds coming from the chest offer additional clues. The last technique used in examination is "touching." Feeling the pulse is a cornerstone of TCM diagnosis and gives the TCM practitioner a lot of information about the body's imbalance.

With stroke, the TCM practitioner will want to diagnose whether it involves the meridians or the viscera (organs) in order to make appropriate treatment decisions.

During the acute stage of a stroke involving the meridians, the TCM practitioner will assess the individual for symptoms of:

Distortion of mouth and tongue
Numbness
Difficulty in speech
Hemiplegia
(paralysis on one side of the body)

During an acute stage of a stroke involving the viscera, the TCM practitioner will assess the individual for symptoms of:

Hemiplegia
(paralysis on one side of the body)
Distortion of mouth and tongue
Paraesthesia of one side of body
Difficulty in speech
Unconsciousness
Problems excreting urine or stool

Note: If a TCM practitioner suspects there might be a serious problem that Chinese medicine alone cannot treat, he or she will normally recommend the individual see a western doctor for further follow up. In the case of a stroke where an individual is experiencing any of the above symptoms, it should be taken very seriously and the appropriate medical care should be sought out preferably in an emergency setting.

If the stroke symptoms are stable and have remained longer than half a year, they are considered to be sequelae symptoms.Damage has already been done to the body that usually cannot be reversed back to its original state of functioning. TCM practitioners in these cases will try to help these individuals gain back as much functioning as they can.