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Stroke | Parkinson | Alzheimer’s | Migraine | Epilepsy seizure | epilepsy | concussion | etc |
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Definition and Types

Stroke is the same word as ‘brain blood vessel disorders’ and often has been called ‘paralyzed’. This disorder is caused by the burst of blood vessels that supply to the brain and the paralysis of the body because of that.

Stroke is divided into two in large: Ischemic stoke and hermorrhagic stroke. Ischemic stoke can be divided into three: Cerebral thrombosis caused by becoming narrow of the blood vessel gradually; intracerebral hemorrhage caused by thrombus burst after falling apart from big blood vessel of heart and neck; cherry-shaped aneurysms or subarachnoid hemorrhage.

1. Infarct
Infarct is a stroke that occurs by clogging of the brain blood vessel. It is divided into two types: thrombotic infarction that blood vessels became narrow gradually by thrombus and finally clogged; embolic cerebral infarction.
 
The cause of thrombotic infarction is arteriosclerosis caused by high blood pressure, hyperlipidemia, and smoking. Embolic cerebral infarction is thrombus that is caused by heart disorders such as cardiac valvular disease or deep vein. These disorders are called ‘risky factors’ overall.
The symptom appears very sudden. The common symptoms are hemiplegia, aphasia, pronounced impairment, dysphagia, headache and vomiting, grogginess, impaired vision, consciousness disturbance, dizziness, diplopia, etc. Sometimes these symptoms get recovered after 24 hours, which is called transient ischemic attacks. This is the sign of the impending infarct.
For diagnosis, first one needs to get a precise treatment from a neurologist and examinations such as CT, MRI, MRA, and angiography.
Treatment can be divided into acute care, rehabilitation, and relapse prevention. Ischemic stroke needs treatment to supply enough blood into the part of ischemia using anticoagulant.
A patient with embolic infarction can consider thrombolytic use when he arrives to the hospital in three hours after the symptom. A surgery is needed in some cases of infarct. Rehabilitation is to be started as soon as possible after stoke has been occurred, and needs for function recovery. In order to prevent relapse, causing disorders should be treated at the same time, and a patient should take anticoagulant for lifetime.


2. Hemorrhage
Hemorrhage is a type of stoke that brain blood vessels are bursted by high blood pressure.
 

It is mostly caused by high blood pressure. It is more easily bursted in brain blood vessels that have arteriosclerosis.
For diagnosis, first a patient should receive an accurate examination, and goes through CT scan.
 
Parkinson’s disease

Etiologyis occurs when neurons that send dopaminergic nerve fibers from substantia nigra in midbrain to striatum are damaged by unknown cause.

Causing factor: postencephalitic parkinsonism, typhus, cerebral syphilis, manganese or phosgene addiction, taking drugs like Phenothiazine or reserpine long-term

Symptoms of Parkinson’s disease
1) Mobility of a patients decreases.
All movement mimics and exercises and related movements disappear gradually. It is difficult to start moving or walking, so first one can walk with very narrow stride and then once walk, it is difficult to stop and needs at least a few steps to stop.

Hypomimia and amimia appear, and a patient do not turn his head, instead move his pupils. Words became few and simple. Dysarthria occurs. When walking, a patient walk very slowly with anteflexed position. As time goes by, a patient does not want to move and does not do ancillary action such as shaking arms.

2) Rigor: continuous resistance of extensor for passive movement Muscles do not relax and when they are force to be relaxed, a patient can feel that the tense of antagonist is decreasing. There is cogwheel phenomenon in head dropping test. Unique postural reflex does not increase opposite from spastic condition and there is no pathologic reflex and paresis.

3) Tramor: frequency 4-8 times per second with rhythmic alternation of agonist and antagonist, so it is called as antagonist tremor. Being different from intention tremor, forward antagonist does not occur during intentional movement.
Particularly, pill-rolling or money-counting figure is the characteristic of parkinson’s disease’s.

A typical symptom of parkinson’s disease is the trembling while awake, which is known very well to public. But this symptom may not happen from the first. In some cases, feeling difficulty in standing up from sitting and moving intentionally can be the first symptom. In other cases, tenses in arm and leg muscle can occur first.

The symptoms appear from the side but later in both after developing for several years. When walking, the back is bent and the feet are dragged with quick and short steps, but it is difficult to turn back and walk to other direction. Face loses facial expressions and becomes mask face, and voice becomes weak and quiet. Arms and legs become stiff and holding the things gets hard, and sometimes accompanied by muscle pain, joint pain, depression, and dementia.

The symptoms appear from 50-60 years old gradually and slowly develop. This diseas is often confused with dementia or depression, and not treated on time by wrong diagnosis. Different from Alzheimer's dementia, Parkinson’s dementia is confused with dementia because the reaction of a patient comes very slow. In the case of terminal patients, the social activity and everyday life becomes difficult, and cardiopulmonary gets degraded, and cannot stand from the bed and die with complications.

Medication is the first thing for Parkinson’s disease. But although medication is received, the development of disease cannot be avoided, so it cannot but be wose and needs more medication, which brings severe side effect.

The common side effects are difficulty in taking medicine due to vomiting, temporary disappearance of symptom, and strange body movement after taking medicine, etc.

The surgery is done only for some patients with stiffness. The medication is limited, and the destructive surgery recently has shown many improvement in recovery of Parkinson’s disease/ The level of satisfaction reaches at about 80%. There are cases the symptom of patients are removed by the surgery which helps patients go back to everyday life by taking little drugs maximizing the treatment effect.
 
Medicine of Parkinson’s disease
 
 
 
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