A case of transient ischemic attack during acupuncture therapy

The importance of medical partnership and the role of the acupuncturist

Abstract

[Objective] We report a case in which we unexpectedly encountered a patient with a transient ischemic attack (TIA) caused by severe stenosis of the left middle cerebral artery (MCA) during the course of acupuncture treatment.Patient: A 79-year-old man suffered from bilateral shoulder pain. He was diagnosed with a frozen shoulder at the orthopedic department and was referred to the acupuncture department.[Results] During the course of acupuncture treatment, the subject occasionally exhibited subtle behavioral features, such as difficulty in speech, holding incoherent conversations, and forgetting where he put things. The symptoms were observed repeatedly during treatment, so the acupuncturist referred the patient to the neurosurgical department for a consultation. Magnetic resonance imaging (MRI) of the brain showed an old cerebral infarction in the watershed area in the left paraventricular region, and MR angiography (MRA) revealed left middle cerebral artery stenosis. Single photon emission computed tomography showed decreased blood flow in the left MCA area. The symptoms could be considered TIA with motor and sensory aphasia. The administration of aspirin was started, and the symptoms disappeared.[Discussion and Conclusion] The acupuncturist has more opportunities to obtain information about the patient due to the longer time spent in acupuncture therapy compared to general outpatient treatment. Acupuncture can play an important role in medical partnership. It is also important that the acupuncturist has sufficient medical knowledge.