Acute Intracranial Hemorrhage in the Brain Caused by Acupuncture

Choo, Daniel Chung Ann; Geng, Yun

doi:10.1046/j.1526-4610.2000.00061.x

Cited by 26 publications

(10 citation statements)

References 3 publications

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“…There were nine cases of central nervous system injury, including five spinal cord injuries [55, 73–75, 77] and four of brain injury [56, 71, 72, 76]. …”

Section: Resultsmentioning

confidence: 99%

Adverse Events of Acupuncture: A Systematic Review of Case Reports

Wang

Cooper

et al. 2013

Evidence-Based Complementary and Alternative Medicine

150

126

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Acupuncture, moxibustion, and cupping, important in traditional Eastern medicine, are increasingly used in the West. Their widening acceptance demands continual safety assessment. This review, a sequel to one our team published 10 years ago, is an evaluation of the frequency and severity of adverse events (AEs) reported for acupuncture, moxibustion, and cupping between 2000 and 2011. Relevant English-language reports in six databases were identified and assessed by two reviewers. During this 12-year period, 117 reports of 308 AEs from 25 countries and regions were associated with acupuncture (294 cases), moxibustion (4 cases), or cupping (10 cases). Country of occurrence, patient's sex and age, and outcome were extracted. Infections, mycobacterial, staphylococcal, and others, were the main complication of acupuncture. In the previous review, we found the main source of infection to be hepatitis, caused by reusable needles. In this review, we found the majority of infections to be bacterial, caused by skin contact at acupoint sites; we found no cases of hepatitis. Although the route of infection had changed, infections were still the major complication of acupuncture. Clearly, guidelines such as Clean Needle Technique must be followed in order to minimize acupuncture AEs.

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“…There were nine cases of central nervous system injury, including five spinal cord injuries [55, 73–75, 77] and four of brain injury [56, 71, 72, 76]. …”

Section: Resultsmentioning

confidence: 99%

Adverse Events of Acupuncture: A Systematic Review of Case Reports

Wang

Cooper

et al. 2013

Evidence-Based Complementary and Alternative Medicine

150

126

View full text Add to dashboard Cite

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“…Among complications of the central nervous system, there have been reports of spinal cord injuries [2-6]. Brain injury is extremely rare, but can happen in the cases in which the needle is placed near the cervico-cranial junction, by migration of the needle through the foramen magnum [1,[7][8][9].In our case, neurological symptoms appeared several days after the acupuncture session, and showed a progressive course. The broken needle had been overlooked and was left in the suboccipital muscle layer.…”

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confidence: 66%

“…Neurological complications are rare but reports have included peripheral nerve injury and spinal cord injuries [1][2][3][4][5][6]. Because of protection by the cranium, complications involving the brain are rare, and only a few cases have been reported [1,[7][8][9]. We report here a rare case of injury to the medulla oblongata due to migration of an acupuncture needle.…”

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confidence: 97%

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Medulla oblongata injury caused by an acupuncture needle; warning for serious complications due to a common method of alternative medicine

et al. 2011

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Acupuncture has become popular and an increasing number of procedures are performed worldwide. While acupuncture is generally considered safe, complications can occur due to its nature of insertion of sharp needles into the skin. Neurological complications are rare but reports have included peripheral nerve injury and spinal cord injuries [1][2][3][4][5][6]. Because of protection by the cranium, complications involving the brain are rare, and only a few cases have been reported [1,[7][8][9]. We report here a rare case of injury to the medulla oblongata due to migration of an acupuncture needle.A 44-year-old man presented with abnormal sensation 6 days after acupuncture treatment for stiff neck. He had felt dull pain on his left cheek and left back teeth after the course of the treatment. However, there was no dental problem on examination by a dentist. On admission, he had dysesthesia and pain in his left leg, and pain in the left V1 and V2 area of the face when he turned his neck. Computed tomography showed an acupuncture needle sticking the medulla oblongata (Fig. 1a), and the tip of the needle was located near the left vertebral artery (Fig. 1b). As there was risk of further injury to medulla oblongata and vertebral artery, emergent surgery was performed under general anesthesia. Extreme care was taken not to move the needle around the procedure to expose the needle. After removal of the needle the surface of the medulla oblongata was observed through a small craniotomy to rule out active bleeding (Fig. 1d). After the operation, facial pain persisted and an abnormal sensation of heat and pain appeared in the right leg. T2-weighted MRI showed a high intensity lesion in the area that had been pricked by the needle (Fig. 1e). His symptoms were gradually relieved, and he was discharged with dysesthesia in the left face and left leg.Although acupuncture is generally considered safe, complications can occur and sometimes result in a serious outcome [10,11]. Among complications of the central nervous system, there have been reports of spinal cord injuries [2-6]. Brain injury is extremely rare, but can happen in the cases in which the needle is placed near the cervico-cranial junction, by migration of the needle through the foramen magnum [1,[7][8][9].In our case, neurological symptoms appeared several days after the acupuncture session, and showed a progressive course. The broken needle had been overlooked and was left in the suboccipital muscle layer. As the tip of the needle remained sharp and the other end was dull, it might have gradually advanced inward piercing the dura mater and becoming lodged to the medulla oblongata. There are several case reports describing the delayed appearance of the symptoms [2,9] due to similar mechanisms.The needle should be removed emergently to prevent further injury of nervous system and vasculature. First, the neck must be immobilized using a hard collar to prevent the needle from progressing further. At the introduction of general anesthesia, the patient was intubated with the h...

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“…1 Another report described spinal epidural hematoma and subarachnoid hemorrhage following acupuncture. 2 MRI findings in our patient indicate a band of abnormal hyperintensity on T1-weighted sagittal imaging, located around the caudal cerebellum.…”

Section: Discussionmentioning

confidence: 99%