Cerebral Insufficiency

Cerebral Insufficiency

Cerebral insufficiency, also known as cerebrovascular insufficiency, is a condition where the blood supply to a specific part of the brain is inadequate, leading to impaired brain function.[1] This condition is often associated with cerebral arteriosclerosis (hardening of the arteries in the brain).

The main symptoms include recurrent episodes of dizziness, lightheadedness, and headaches. These are often accompanied by irritability, tinnitus (ringing in the ears), restlessness, insomnia, vivid dreaming, memory decline, lack of concentration, and forgetfulness. Research suggests that if left untreated, cerebral insufficiency can potentially lead to cerebral infarction (stroke) or even dementia.

Causes

1. Cervical Spine Issues: Misalignment of the atlantoaxial joint (the first and second cervical vertebrae) or the C5-C6 cervical joint can irritate the vertebral artery, causing the arterial passage to narrow or spasm. This reduces blood flow and leads to insufficient supply to the areas of the brain it serves.

2. Hemodynamic Disturbances: Brain tissue may not receive enough blood when there is a drop in blood pressure or a decrease in the heart’s output.[2][3][4]

3. Changes in Blood Properties: An increase in blood viscosity (thickness) for any reason, a slowing of blood flow, or changes in the composition of the blood can also lead to insufficient supply.

4. Microthrombus Formation: Microthrombi can form when plaque from atherosclerosis breaks off, creating tiny emboli in the bloodstream. These can travel to smaller arteries and block them, causing a localized lack of blood supply in the brain.

Clinically, cerebral insufficiency is categorized as either acute or chronic. Acute cerebral insufficiency (acute cerebral ischemia) is a common condition in the elderly and receives significant clinical attention. However, chronic cerebral insufficiency often goes unnoticed.[5]

Clinical Manifestations

1. Abnormalities in Mental State and Consciousness:

• A persistent desire to sleep or feeling drowsy all day, not caused by excessive fatigue, can be an early sign.

• Some individuals may experience insomnia.

• Personality changes, such as becoming reclusive, quiet, or emotionally indifferent, or conversely, becoming talkative and irritable, may occur.

• There can be brief episodes of memory loss or a decline in intellectual function, even to the point of losing normal judgment.

2. Motor Nerve Dysfunction:

• This is one of the most common early signs.

• The lack of blood supply can impair the nerves that control the body’s movement.[6]

• Common signs include sudden facial drooping, drooling, difficulty speaking or slurred speech, aphasia (inability to speak or understand language), difficulty swallowing, weakness or clumsiness in a limb on one side of the body, dropping objects, and unsteady gait or sudden falls.[2][7][8]

• Some may experience muscle spasms or twitching in the limbs.

3. Sensory Function Impairment:

• Insufficient blood supply can affect the sensory analysis areas of the brain.

• This often manifests as numbness in the face, tongue, or lips, or a feeling of numbness or a foreign object sensation in a limb on one side of the body.

• Some may experience blurred vision or even temporary blindness.

• Many report a sudden feeling of dizziness or vertigo.[2][8]

• Spontaneous pain in the limbs may occur.

• Sudden tinnitus or a decrease in hearing are also possible symptoms.

Treatment

Western Medical Treatment

• Removal of Risk Factors: This includes managing high blood pressure, quitting smoking, and avoiding excessive alcohol consumption.

• Antiplatelet Drugs: Aspirin is often the first choice. Antiplatelet medications help prevent platelets from clumping together, which improves blood circulation and blood flow to the brain.

• Anticoagulant Drugs: Similar to antiplatelet drugs, anticoagulants help to ensure smooth blood flow, increasing the blood supply to the brain and reducing the risk of ischemic events.

• Surgical Treatment: If there is severe stenosis (narrowing of over 70%) in the carotid artery, a carotid endarterectomy (surgical removal of plaque) or carotid artery stenting may be necessary.[1]

Traditional Chinese Medicine (TCM) Treatment

• Liver Fire Rushing Upward:

  • Symptoms: Dizziness, vertigo, tinnitus, a distending headache, insomnia, vivid dreaming, irritability, and a flushed face. The tongue is red, and the pulse is wiry.

  • Treatment Principle: Clear Liver fire, and open and activate the channels and collaterals.

• Phlegm-Turbidity Obstructing the Collaterals:

  • Symptoms: Dizziness, a heavy sensation in the head, vertigo, numbness in the limbs, a bitter taste in the mouth, dry mouth, obesity, abdominal bloating, and constipation. The tongue is red with a yellow or dry coating, and the pulse is wiry and rapid.

  • Treatment Principle: Expel phlegm, open the collaterals, raise the clear Yang, and descend the turbid Yin.

• Kidney Essence Deficiency:

  • Symptoms: Dizziness, a feeling of emptiness in the head, headache, tinnitus, blurred vision, soreness in the lower back and knees, frequent nighttime urination, and weakness in the lower limbs. The tongue is red, and the pulse is deep, thin, and weak.

  • Treatment Principle: Tonify the Kidneys and replenish essence, nourish the blood, and enrich the brain.

• Qi Deficiency and Blood Stasis:

  • Symptoms: Dizziness, fatigue, numbness in the limbs, palpitations, shortness of breath, swelling in the hands and feet, and a pale complexion. The tongue is pale and dusky, the coating is white, and the pulse is thin and choppy or thin and slow.

  • Treatment Principle: Tonify Qi, activate blood, and open the collaterals.

• Yin Deficiency and Yang Hyperactivity:

  • Symptoms: Dizziness, vertigo, tinnitus, dry mouth, a feeling of heaviness in the head and lightness in the feet, unsteady gait, palpitations, insomnia, and numbness in the limbs. The tongue is red and dry with little coating, and the pulse is wiry and thin.

  • Treatment Principle: Nourish Yin, subdue Yang, and open the collaterals to move stasis.

Prevention

1. Timely Treatment: The primary goal is to improve cerebral circulation. Vasodilators and Ginkgo Biloba preparations may be used under a doctor’s guidance.

2. Early Prevention: The focus of prevention is on the health of the cerebral blood vessels. In particular, high cholesterol and high low-density lipoprotein (LDL) levels should be addressed.

3. Healthy Diet: Regularly consume fresh vegetables like onions and tomatoes, as well as fruits, fish, black fungus, a small amount of vinegar, and dry red wine. These can have an antioxidant effect and help to delay the onset of cerebral arteriosclerosis.

4. Appropriate Outdoor Activities: Engage in activities like brisk walking, jogging, or leisurely walks for 30-40 minutes at least 5 days a week. Tai Chi, fishing, or hiking are also beneficial.

5. Maintain a Positive Attitude and Keep the Brain Active: Watch TV, read newspapers, do crafts or household chores, or participate in cultural and recreational activities like singing, dancing, calligraphy, or playing games. This can elevate your mood and enhance mental activity. Avoid emotional agitation and excessive fatigue.