Insufficient Cerebral Blood Supply

Insufficient cerebral blood supply refers to a condition where a specific area of the brain does not receive enough blood, leading to impaired brain function. It is often associated with cerebral arteriosclerosis (hardening of the arteries in the brain).

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

Causes

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

2. Hemodynamic Disorders: When blood pressure drops and cardiac output decreases, the brain tissue may not receive an adequate blood supply.

3. Increased Blood Viscosity: Certain conditions that cause the blood to become thicker, slow down, or change in composition can also lead to insufficient blood supply.

4. Microthrombus Formation: Microthrombi are tiny clots that can form when plaques from atherosclerosis break off. These small emboli can travel with the bloodstream to smaller arteries and block them, causing a localized lack of blood supply to the brain.

Clinically, insufficient cerebral blood supply is divided into acute and chronic forms. Acute cerebral insufficiency (acute cerebral ischemia) is a common condition in the elderly and is generally given due-clinical attention. However, chronic cerebral insufficiency often receives less attention.

Clinical Manifestations

1. Abnormal Mental State and Consciousness:

   • Feeling constantly sleepy or drowsy, not due to excessive fatigue, can be an early warning sign.
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   • Some individuals may experience insomnia.

   • Personality changes can occur, such as becoming reclusive, taciturn, or emotionally flat. Others may become talkative and irritable.

   • There may be temporary loss of consciousness or a decline in intellectual function, even a loss of normal judgment.

2. Motor Nerve Dysfunction:

   • This is one of the most common warning signs. Insufficient blood supply can cause the nerves that control motor functions to fail.

   • Common manifestations include a sudden crooked mouth, drooling, difficulty speaking, slurred speech, aphasia (inability to speak or understand language), difficulty swallowing, weakness or clumsiness in one limb, dropping objects, unsteady gait, or sudden falls. Some may experience limb spasms or twitching.

3. Sensory Dysfunction:

   • When insufficient blood supply affects the brain’s analytical areas, sensory organs, or sensory nerve fibers, it can manifest as numbness in the face, tongue, or lips, as well as numbness or a strange sensation in one limb.

   • Some people may experience blurred vision or even sudden temporary blindness.

   • Many experience sudden dizziness.

   • Some may have spontaneous pain in the limbs.

   • Others may experience a sudden onset of tinnitus or hearing loss.

Treatment

Western Medicine Treatment

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

2. Antiplatelet Drugs: Aspirin is the first choice. These drugs effectively prevent platelets from clumping together, which is beneficial for blood circulation and cerebral blood supply.

3. Anticoagulant Drugs: These drugs have a similar effect to antiplatelet drugs, helping to keep the blood flowing smoothly, increasing blood supply to the brain, and reducing the risk of ischemic events.

4. Surgical Treatment: If there is severe stenosis (narrowing of over 70%) in the carotid artery, procedures such as carotid endarterectomy or carotid artery stenting may be necessary.

Traditional Chinese Medicine (TCM) Treatment

1. Liver Fire Rushing Upward:

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

   • Treatment Principle: Clear Liver fire, unblock the vessels, and invigorate the collaterals.

2. Phlegm-Turbidity Obstructing the Collaterals:

   • Symptoms: Dizziness, a heavy head, vertigo, numbness in the limbs, a bitter and dry mouth, an overweight physique, abdominal bloating, and dry stools. The tongue is red with a yellow or dry coating, and the pulse is wiry, rapid, and strong.

   • Treatment Principle: Expel phlegm, unblock the collaterals, raise the clear Qi, and descend the turbid.

3. Kidney Essence Deficiency:

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

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

4. Qi Deficiency and Blood Stasis:

   • Symptoms: Obstruction of the vessels and collaterals, dizziness, fatigue, numbness in the limbs, heart palpitations, shortness of breath, swelling in the hands and feet, and a pale complexion. The tongue is pale and dark with a white coating, and the pulse is thready and choppy or thready and slow.

   • Treatment Principle: Tonify Qi, invigorate blood, and unblock the collaterals.

5. Yin Deficiency with Yang Hyperactivity:

   • Symptoms: Stagnation in the vessels and collaterals, dizziness, vertigo, tinnitus, a dry mouth, a heavy head with light feet, an unsteady gait, heart palpitations, insomnia, and numbness in the limbs. The tongue is red and dry with a scanty coating, and the pulse is wiry and thready.

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

Prevention

1. Timely Treatment: The main goal is to improve cerebral blood circulation. This can be done under a doctor’s guidance with vasodilator drugs and Ginkgo biloba preparations.

2. Early Prevention: The focus of prevention is on the cerebral blood vessels, especially managing high cholesterol and low-density lipoprotein (LDL) levels.

3. Reasonable Diet: Eat plenty of fresh vegetables (like onions and tomatoes), fruits, fish, and black fungus. A small amount of vinegar and dry red wine can also have an antioxidant effect, helping to delay the onset of cerebral arteriosclerosis.

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

5. Maintain a Good Mental State and Use Your Brain Healthily: Watch TV, read newspapers, and do some crafts or housework. Participate in cultural and sports activities like singing, dancing, calligraphy, or playing ball games to cultivate a good temperament and enhance brain activity. Avoid emotional agitation and excessive fatigue.