Overview
Cerebrovascular Accidents e.g. acute cerebrovascular disease refers to the disease with acute or sub acute brain injury symptoms such as hemiplegia, aphasia and coma etc, which are caused by acute dysfunction of blood circulation. The disease usually affects the middle-aged and old people especially those with hypertension and arteriosclerosis characterized by sudden attack, high mortality and maim. According to the nature of the disease, it can be divided into two parts, hemorrhagic disease including cerebral hemorrhage as well as subarachnoid space bleeding, ischemic disease consisted of cerebral infarction, cerebral embolism and cerebral, thrombosis. In TCM, if the patient who usually has serious deficiency of blood and qi and the disharmony between Yin and Yang involved with the heart, liver and kidney suffers from emotional injuries such as melancholy, worry and anger or improper diet, or sex intemperance, or attack by exogenous evils. Then the wind, fire, phlegm and stasis will block the cerebral collaterals, thus causing the disease. The disease which is deficient in the root and excessive in the branch involves with the cerebral orifice and cerebral collaterals heart, liver, spleen and kidney. The acute phase usually shows excess in the branch except the apoplectic depletion syndrome. While the convalescence shows deficiency mingling with excess. The acupuncture treatment for obstructive syndrome of apoplexy involving Zang and Fu organs is to sedate the liver and extinguish the wind, clear away heart to resolve phlegm for resuscitation. The apoplectic depletion syndrome should be treated by reviving Yang to stop collapse. Regulating qi and blood in the meridians should be adopted to cure apoplexy involving, meridians and collaterals.

Treatment
1. Shuigou (DU 26)
It's applied into the obstructive syndrome of apoplexy involving zang and fu organs. Filiform needle acupuncture should be adopted. When operating, hold the needle with the right hand and puncture upward obliquely 0.5 cun to make a sensation of soreness and distention, but not to cause restlessness. Treat the patient 2 or 3 times a day until he (she) sobers up.

2. Baihui (DU 20)
In the acute phase, insert a needle into DU20 horizontally backwards into the subgaleal layer at the angle of 30. Then twirl the needle with a mediate stimulation to make the patient have a strong sensation of arrival of qi. The needle is retained for a long time. One or Two times a day and ten treatments make up of one course. In the chronic phase, with a needle of 28# or 30# in size and 1.5-2 cun in length, puncture DU20 from the scalp and pierce continuously with three relays toward the direction of GB7 point. Twirl rapidly for 200 times per minute for 5 minutes, with a 5-minute-break. It should be repeated for 3 times. Withdraw the needle about 30 minutes later. One treatment daily and 15 treatments make up of one course.

3. Shenque (RN 8)
It's applied into the acute apoplectic depletion syndrome. Moxibustion with salt is applied to this point for a period of tens of cones being ignited until perspiration stops, limbs get warm and the pulse restores normal.

4. Renying (ST 9)
It's applied in the hemiplegic patients resulted from cerebrovascular accidents. Localize the patient in the supine position. After routine sterilization, palpate the carotis with the forefinger and middle finger of the left hand. Then pierce into the derma rapidly with a filiform needle sized 28# in the right hand, avoiding the carotis and acteria cervical is superficial is, at last slows bring the needle into the skin, when the patient has a sensation of soreness, distention, sinking and paralysis, twirl in a small scale for about 1-2 minutes and withdraw the needle. The acupuncture depth is decided by the circumference of the neck. Generally speaking, if the neck circumference is 29-34 cm long, then acupuncture 2-2.5 cun in depth, if the neck circumference is 35-42 cm long, then acupuncture 2.5-4 cun. Ten treatments make up of one course. Continue the treatment if the patient feel well. If he (she) feels tired, a two or three- day-break should be taken.

5. Chize (LU 5)
It's applied in the hemiplegic patients caused by cerebrovascular accidents. Based on ZiWuliuzhu Method, every day at 3-5 a.m. before the patient wakes up, locate LU5 in the lung meridian of hand TaiYin, and then rapidly insert the needle with strong stimulation to make the patient feel thearrival of qi, Needle Retention: 10-20 minutes during which the needle is twirled 1-2 times. The acupuncture depth should be 1-1.5 cun. 10 days make up of one course.

6. Lianquan (RN 23)
It's used for aphasia due to stiff-tongue and difficulty in swallowing. Puncture obliquely 0.5 -0.8 cun towards the tongue root, or apply the multi-directional needling to the left or right. Needle retention: 10-20 minutes, one treatment daily and 10 treatments make up of one course.

Note
At present, the postapoplectil sequelae haven't had the standard treatment. Acupuncture is an effective therapeutic method, not only used in the convalescence and the latter strange of sequelae, but also in the acute stage and presentation. Besides the routine acupuncture method, the point penetration Method of piercing into several points with the needle is applicable. Besides the treatment for paralysis body and dysphasia etc. the doctor should pay attention to the general conditions of the patient such as the blood pressure, diet, sleep and stool, and then offer the correct acupuncture methods which shouldn't be ignored in order to achieve a better treatment effect. During the treatment period, reinforcing in the function exercise can promote the flow and qi and blood in the meridians and collaterals, strengthen the nutritional function of the nerves and prevent the changes of disuse in the muscle, bone and joints.