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  • Physician Juli & Mr Sim CS


Updated: Oct 23, 2021


A “Stroke” occurs when the blood supply to part of your Brain is interrupted or reduced, preventing Brain Tissue from getting oxygen and nutrients. Brain Cells begin to die in minutes.

Stroke” is a Cerebrovascular Disease. This means that it affects the blood vessels that feed the brain oxygen. If the brain does not receive enough oxygen, damage may start to occur.

Stroke” is a medical emergency. Although many strokes are treatable, some can lead to disability or death.


The various Types of Strokes are as follows:

(1) Ischemic Stroke

An “Ischemic Stroke” is the most commonly occurring type of stroke. It occurs when a clot in a blood vessel interferes with adequate blood flow to the brain. A blood clot that travels from one area of the body to a blood vessel in the Brain may also cause an Ischemic Stroke.

Blood clots typically form in areas where the arteries have been narrowed or blocked by fatty cholesterol-containing deposits known as “Plaques”.

There are TWO types of “Ischemic Stroke”:

a. Thrombotic Stroke

A “Thrombotic Stroke” occurs when a blood clot impairs the blood flow in an Artery that supplies blood to the Brain.

b. Embolic Stroke

An “Embolic Stroke” occurs when a blood clot that forms elsewhere in the body (“Embolus”) breaks loose and travels to the Brain via the bloodstream. Eventually, the clot lodges in a blood vessel and blocks the flow of blood, causing a Stroke.

Symptoms of an Ischemic Stroke

The typical Symptoms of an “Ischemic Stroke” may include:

(1) Sudden numbness in any area of the body.

(2) Weakness on one side of the body.

(3) Drooping on one side of the face.

(4) Vision changes, especially in just one eye.

(5) Dizziness or a loss of coordination.

(6) Difficulty walking.

(7) Confusion.

(8) A sudden, very intense headache with no known cause.

Associated Risk Factors for an Ischemic Stroke

Although anyone can experience an ‘Ischemic Stroke”, certain groups may however have a higher risk. Some of these Risk Factors for an “Ischemic Stroke” may include:

(1) Being female, as females tends to live longer and are therefore more likely to live long enough to have a Stroke.

(2) Having “Vasculitis”, which is a type of blood vessel inflammation.

(3) having “Atherosclerosis”, which is a condition that causes fatty plaques to build up in the walls of the Arteries.

(4) Smoking.

(5) Drinking lots of alcohol.

(6) Not getting very much exercise.

(7) Being over the age of 65 years.

(8) Having Atrial Fibrillation (“A-Fib”), which is a heart condition that causes a rapid or irregular heart rate.

Treatment Options for Ischemic Stroke

There is currently no cure for “Ischemic Stroke”. Instead, urgent treatment focuses on removing the clot and preventing any further Brain Damage.

The first line of treatemtn tends to include a “Tissue Plasminogen Activator”, or “Alteplase”. Administering this treatment through a vein in the arm can help quickly dissolve the blood clot and improve the blood flow to the affected area of the Brain.

In some situations, it may become necessary to surgically dissolve or remove the clot using a procedure called “Thrombectomy”. The success of “Thrombectomy” works best when a Surgeon performs it within 6 hours of the onset of Stroke Symptoms. However, “Thrombectomy” may improve the outcomes up to 24 hours after a Stroke.

To help a person regain functioning and cope with the stress of having a Stroke, they may need a variety of supportive treatments. These may include:

(1) Speech Therapy.

(2) Occupational Therapy.

(3) Physical Therapy.

(4) Psychological Therapy.

A medical Doctor may also recommend making certain lifestyle changes, such as adopting a Lower Fat Diet or Exercising more often, to reduce the further risks of experiencing another Stroke.

(2) Hemorrhagic Stroke

A “Hemorrhagic Stroke” occurs when a blood vessel either “Ruptures” or “Leaks”, causing “Bleeding” into the Brain. The blood that accumulates from the bleeding “Compresses” the surrounding Brain Tissue.

There are TWO types of weakened blood vessels:

a. Aneurysms

An “Aneurysm” is a ballooning of a weakened region of a blood vessel. If left untreated, the “Aneurysm” continues to “Weaken” the blood vessel until they “Ruptures” and “Bleeds” into the Brain.

b. ArterioVenous Malformations (AVMs)

An “ArterioVenous Malformation” (AVM) is a cluster of abnormally formed blood vessels. Any one of these vessels can “Rupture”, also causing “Bleeding” into the Brain.

Like other Strokes, a “Hemorrhagic Stroke” can cause “Rapid Tissue Death”.

Symptoms of a Hemorrhagic Stroke

The typical Symptoms of a “Hemorrhagic Stroke” are similar to those of an “Ischemic Stroke” and may include:

(1) Numbness.

(2) Loss of function, especially on one side of the body.

(3) Drooping on one side of the face.

(4) Trouble speaking.

(5) Loss of consciousness.

(6) Confusion.

(7) Severe headache.

(8) Seizure.

Associated Risk Factors for an Hemorrhagic Stroke

The TWO potential causes of “Hemorrhagic Stroke” are:

a. Aneurysms

An “Aneurysm” is an enlarged, ballooning blood vessel. This change in a blood vessel’s size and shape increases the risk that it will “Rupture”, causing a “Bleed”.

Many people with “Aneurysms” do not typically have symptoms, and most “Aneurysms” will appear after the age of 40.

An “Aneurysm” can be “Congenital” or “Hereditary”, or it can develop due to Risk Factors.

The Risk Factors for an “Aneurysm” may include:

(1) Having high blood pressure.

(2) Smoking.

(3) Drinking a lot of alcohol.

(4) Using drugs, such as cocaine.

(5) Being female.

(6) Having experienced Head Trauma.

b. ArterioVenous Malformations (AVMs)

An “ArterioVenous Malformations”(AVMs), on the other hand, is a “Misshapen Blood Vessel”. Only about 1% of the population have an AVM. Most people with an AVM are usually born with it.

The “Misshapen Blood Vessel” may “Rupture” or “Bleed”, causing a “Hemorrhagic Stroke”.

Rarely, a “Hemorrhagic Stroke” can happen due to a sudden “Blood Vessel Injury”, such as from:

(1) Whiplash.

(2) Head Trauma.

(3) Holding the head in an unusual position.

Some isolated reports even suggest that some Chiropractic Neck Treatments not performed properly can cause “Bleeding” in some people. In these cases, it is likely that the person had some underlying risk factors, such as an “Aneurysm”.

Treatment Options for Hemorrhagic Stroke

Sometimes, a Health Professional can surgically remove the blood and repair the blood vessel. However, it is often necessary to manage “Hemorrhagic Strokes” with fluid control and monitor for effects such as “Seizures”.

To reduce the risk of “Brain Damage”, a Medical Doctor may also give some medication to control the patient’s blood pressure.

(3) Transient Ischemic Attack (“TIA” - Mini-Stroke)

A “Transient Ischemic Attack (TIA)”, sometimes called a “Ministroke”, is similar to an Ischemic Stroke in that it temporarily blocks blood flow to the Brain. However, unlike an Ischemic Stroke, Health Professionals do not believe that “Transient Ischemic Attacks (TIAs)” cause lasting “Brain Damage”.

It usually recovers within 24 hours. Like an “Ischemic Stroke”, a “Transient Ischemic Attack (TIA)” occurs when a clot or debris blocks blood flow to part of your Brain. A “Transient Ischemic Attack (TIA)” doesn't leave lasting symptoms because the blockage is temporary.

It however, still needs immediate intervention, to distinguish it from an actual stroke, and is often also considered as an indicator of the possibility of another stroke.

Symptoms of a Transient Ischemic Attack (TIA)

The typical Symptoms of a “Transient Ischemic Attack (TIA)” are similar to those of an “Ischemic Stroke” and may include:

(1) Confusion.

(2) Trouble Waking.

(3) Drooping on one side of the face.

(4) Tingling or Numbness.

However, the symptoms tend to be less severe and last just a few minutes. Unlike an “Ischemic Stroke”, a “Transient Ischemic Attack (TIA)” resolves on its own, when the clot either moves or dissolves.

Associated Risk Factors for a Transient Ischemic Attack (TIA)

The risk factors for a “Transient Ischemic Attack (TIA)” are the same as those for an ischemic stroke and include:

(1) Being older.

(2) Smoking.

(3) Getting little exercise.

(4) Having Cardiovascular Disease.

(5) Having “A-Fib”.

Transient Ischemic Attacks (TIAs)” occur before about 15% of strokes. This means that many people who experience a “Transient Ischemic Attacks (TIAs)” will experience an “Ischemic Stroke” in the future.

A person who has a “Transient Ischemic Attack (TIA)” should talk to a Doctor about the Lifestyle Changes, Medications, and Other Treatment Options that can reduce the risk of experiencing an “Ischemic Stroke”.

(4) Brain Stem Stroke

A “Brainstem Stroke” can cause impairments in vital body functions, like breathing, heartbeat, swallowing, and speech, due to a blockage of blood between the Brainstem and the Brain. The effects can be catastrophic to a stroke patient and may prove difficult to recover from.

Fortunately, fast treatment and the beginning of the “Recovery Process” as soon as possible can make a significant difference in the well-being of a patient after a “Brainstem Stroke”. It’s important that you learn why a “Brainstem Stroke” occurs, how it’s diagnosed and treated, and what the proper “after-stroke recovery” is.

Signs and Symptoms of Brainstem Stroke

There are basically 5 key features of a "Brainstem Stroke":

(1) Vertigo

Brainstem Strokes” interrupt the connection of the Brain and Cerebellum. The Cerebellum controls face and body coordination so a disruption can leads to “Vertigo”. If the patient has “Vertigo”, it should immediately point toward a “Brainstem Disorder”.

(2) Presence of Cranial Nerve Symptoms

The “Cranial Nerves” emerges directly from the Brainstem. There are 12 pairs of “Cranial Nerves”, all of which control “Motor” and “Sensory” information in the head and neck. Recognizing the “Cranial Nerve Symptoms” can help determine where the Stroke occurred. Common “Cranial Nerve Symptoms” caused by a “Brainstem Stroke” are upward drifting in the affected eye, a dilated pupil, and double vision.

(3) Presence of Crossed Signs

In other words, this is presence of “Ipsilateral” (“same side”) Motor and Sensory Cranial Nerve signs or symptoms and “Contralateral” (“opposite side”) “Hemianesthesia” (“loss of sensation”) and “Hemiplegia” (“weakness”).

(4) Presence of Oculomotor Signs

The “Oculomotor Nerve” is a “Cranial Nerve” which is a part of the eyelid movement and the eyes’ ability to focus on an object. Damage to this “Oculomotor Nerve” can be recognized by what are known as “Down ‘n Out” symptoms, where is the gaze of the affected eye being focused down and lateral of the unaffected eye.

(5) Bilateral Simultaneous Involvement of Long Tracts

This includes either Sensory or Motor, Symmetric or Asymmetric, Simultaneous or Sequential. For example, if there is a Stroke patient who has “Simultaneous Bilateral Hemiparesis” (“weakness”) or “Sequential Hemiparesis”, first on one side of the body and then after a while or the next day on the other side, it points to the Disorder in the Brainstem.

The common symptoms that a patient may display while having a “Brainstem Stroke” may include some of the followings:

(1) Difficulty breathing.

(2) Difficulty speaking.

(3) Problems with chewing and swallowing.

(4) Partial or complete hearing loss.

(5) Blurred vision.

(6) Weakness of the limbs.

(7) Paralysis.

(8) Numbness or loss of sensation.

(5) Cryptogenic Stroke (Stroke of Unknown Cause)

Cryptogenic Stroke” (CS) is defined as “Cerebral Ischemia of Obscure or Unknown Origin”. The cause of “Cryptogenic Stroke” (CS) remains undetermined because the event is “Transitory” or “Reversible”. Investigations did not look for all possible causes, or because some causes truly remain unknown. One third of the “Ischemic Strokes” is “Cryptogenic”.

The typical symptoms of a “Cryptogenic Stroke” may include:

a. Irregular heartbeats.

b. Thumping or pounding heartbeats.

c. A feeling that the heart is racing.

d. Chest discomfort.

e. Fainting or light-headedness.

f. Fatigue, shortness of breath or weakness.


While you may not be the actual person who may be suffering a Stroke, learning how to identify theSigns and Symptoms of a Stroke may help to save the lives of the people next to you who may be suffering a Stroke around you. Some of these common signs and symptoms may include:

(1) Having Trouble Speaking and Understanding What Others Are Saying

When a person is having a “Stroke”, they may experience some trouble speaking and understanding what others are saying to them. They may also experience confusion, slurring in their words or have difficulty understanding speech.

(2) Paralysis or Numbness of the Face, Arm or Leg

You may develop sudden Numbness, Weakness or Paralysis in your face, arm or leg. This often affects just one side of your body. Try to raise both your arms over your head at the same time. If one arm begins to fall, you may be having a “Stroke”. Also, one side of your mouth may droop when you try to smile.

(3) Problems Seeing in ONE or BOTH Eyes

You may suddenly have “Blurred” or “Blackened” vision in ONE or BOTH eyes, or you may see double.

(4) Headache

A sudden, severe headache, which may be accompanied by vomiting, dizziness or altered consciousness, may indicate that you're having a “Stroke”.

(5) Trouble Walking

You may stumble or lose your balance. You may also have sudden dizziness or a loss of coordination.


There are many factors which can increase your Stroke risk. Potentially treatable, “Stroke” risk factors may include:

(1) Lifestyle Risk Factors

Some of these “Lifestyle Risk Factors” for “Stroke” may include:

a. Being Overweight or Obese.

b. Physical Inactivity.

c. Heavy or Binge Drinking.

d. Use of Illegal Drugs such as Cocaine and Methamphetamine.

(2) Medical Risk Factors

Some of these Medical Risk Factors for “Stroke” may include:

a. High blood pressure.

b. Cigarette smoking or secondhand smoke exposure.

c. High cholesterol.

d. Diabetes.

e. Obstructive Sleep Apnea (OSA).

f. Cardiovascular Disease, including heart failure, heart defects, heart infection

or abnormal heart rhythm, such as atrial fibrillation.

g. Personal or family history of “Stroke”, Heart Attack or

Transient Ischemic Attack” (TIA).

h. COVID-19 infection.

Other Risk Factors associated with a higher risk of “Stroke” can include:

a. Age

People age 55 or older have a higher risk of “Stroke” than do younger people.

b. Race

Certain races may have a higher risk of “Stroke” than do people of some other races.

c. Sex

Men may have a higher risk of “Stroke” than women. Women are usually older when they have “Strokes”, and they're more likely to die of “Strokes” than are men.

d. Hormones

Use of birth control pills or hormone therapies that include “Estrogen” may also increases the risk of “Strokes”.


A “Stroke” can sometimes cause “Temporary” or “Permanent” disabilities, depending on how long the Brain lacks blood flow and which part of the Brain was affected. Some of these “Complications” may include:

(1) Paralysis or Loss of Muscle Movement

You may become “Paralyzed” on one side of your body, or lose control of certain muscles, such as those on one side of your face or one arm.

(2) Difficulty Talking or Swallowing

A “Stroke” might affect the control of the muscles in your mouth and throat, making it difficult for you to talk clearly, swallow or eat. You also may have difficulty with language, including speaking or understanding speech, reading, or writing.

(3) Memory Loss or Thinking Difficulties

Many people who have had “Strokes” experience some “Memory Loss”. Others may have difficulty thinking, reasoning, making judgments and understanding concepts.

(4) Emotional Problems

People who have had “Strokes” may have more difficulty controlling their “Emotions”, or they may develop “Depression”.

(5) Pain

Pain, Numbness or Other Unusual Sensations may occur in the parts of the body affected by “Stroke”. For example, if a “Stroke” causes you to lose feeling in your Left Arm, you may develop an uncomfortable tingling sensation in that arm.

(6) Changes in Behavior and Self-Care Ability

People who have had “Strokes” may become more “Withdrawn”. They may need help with grooming and daily chores.


Knowing your OWN “Stroke” risk factors, following your medical Doctor’s recommendation by adopting a “Healthy Lifestyle” are the best steps you can take to preventing a “Stroke”. If you've had a “Stroke” or a “Transient Ischemic Attack” (TIA), these measures might help you to prevent another “Stroke”. The follow-up care you receive in the hospital and afterward also may play an important role in the Prevention of yet another “Stroke”.

Many “Stroke Prevention Strategies” are the same as strategies to prevent heart disease. In general, a “Healthy Lifestyle” recommendation may include:

(1) Controlling High Blood Pressure (“Hypertension”)

This is one of the most important things you can do to reduce your “Stroke” risk. If you've had a “Stroke”, lowering your blood pressure can help prevent a subsequent “Transient Ischemic Attack” (TIA) or “Stroke”. “Healthy Lifestyle” changes and medications are often used to treat high blood pressure.

(2) Lowering the amount of cholesterol and saturated fat in your Diet

Eating less Cholesterol and Fat, especially Saturated Fat and Trans Fats, may reduce the buildup of Plaques in your arteries. If you can't control your Cholesterol through dietary changes alone, your medical Doctor may prescribe a “Cholesterol-Lowering Medication”.

(3) Quitting Tobacco Use

Smoking raises the risk of “Stroke” for smokers and nonsmokers exposed to secondhand smoke. Quitting tobacco use reduces your risk of “Stroke”.

(4) Managing Your Diabetes

Diet, exercise and losing weight can help you keep your blood sugar in a healthy range. If lifestyle factors don't seem to be enough to control your Diabetes, your medical Doctor may prescribe Diabetes medication.

(5) Maintaining a Healthy Weight

Being overweight contributes to other “Stroke” risk factors, such as high blood pressure, cardiovascular disease and diabetes.

(6) Eating a Diet Rich in Fruits and Vegetables

A Diet containing five or more daily servings of fruits or vegetables may reduce your risk of “Stroke”. The Mediterranean Diet, which emphasizes olive oil, fruit, nuts, vegetables and whole grains, may be helpful.

(7) Exercising Regularly

Aerobic Exercise reduces your risk of “Stroke” in many ways. Exercise can lower your blood pressure, increase your levels of good Cholesterol, and improve the overall health of your blood vessels and heart. It also helps if you were to lose weight, control your Diabetes and reduces your stress. Gradually work up to at least 30 minutes of moderate physical activity — such as walking, jogging, swimming or bicycling — on most, if not all, days of the week.

(8) Drinking Alcohol in Moderation, if at all

Heavy alcohol consumption increases your risk of high blood pressure, “Ischemic Strokes” and “Hemorrhagic Strokes”. Alcohol may also interact with other drugs that you're taking. However, drinking small to moderate amounts of alcohol, such as one drink a day, may help prevent “Ischemic Stroke” and decrease your blood's clotting tendency. Talk to your Doctor about what's appropriate for you.

(9) Treating Obstructive Sleep Apnea (OSA)

Your medical Doctor may recommend a “Sleep Study” if you have symptoms of “Obstructive Sleep Apnea” (OSA) — a sleep disorder that causes you to stop breathing for short periods repeatedly during sleep. Treatment for “Obstructive Sleep Apnea” (OSA) includes a device that delivers positive airway pressure through a mask to keep your airway open while you sleep.

(10) Avoiding Illegal Drugs

Certain types of street drugs, such as Cocaine and Methamphetamine, are established risk factors for a “Transient Ischemic Stroke” (TIA) or a “Stroke”.


If you've already had an “Ischemic Stroke” or “Transient Ischemic Stroke” (TIA), your medical Doctor may likely recommend certain “Preventive Medications” to help reduce your risk of having another “Stroke”. Some of these medications may include:

(1) Anti-Platelet Drugs

Platelets” are cells in your blood that form clots. “Anti-platelet Drugs” make these cells less sticky and less likely to clot. The most commonly used “Anti-Platelet Medication” is “Aspirin”. Your doctor can help you determine the right dose of “Aspirin” for you.

Your doctor might also consider prescribing “Aggrenox”, a combination of “Low-Dose Aspirin” and the “Anti-Platelet Drug Dipyridamole” to reduce the risk of blood clotting. After a “Transient Ischemic Stroke” (TIA) or “Mini Stroke”, your Doctor may give you “Aspirin” and an “Anti-Platelet Drug” such as “Clopidogrel (Plavix)” for a “peraViod of time” to reduce the risk of another “Stroke”. If you can't take “Aspirin”, your Doctor may prescribe “Clopidogrel” alone.

(2) Anticoagulants

These drugs reduce blood clotting. “Heparin” is fast acting and may be used short-term in the hospital.

Slower-acting “Warfarin” (“Coumadin”, “Jantoven”) may be used over a longer term. “Warfarin” is a powerful blood-thinning drug, so you'll need to take it exactly as directed and watch for side effects. You'll also need to have regular blood tests to monitor “Warfarin's Effects”. The main side effect of “Warfarin” is Bleeding. While the risk of major bleeding is low, you need to be aware of potential problems. For example, you might have trouble stopping the bleeding from a cut on your hand or a nosebleed. More-serious bleeding may occur inside the body (internal).

Several newer “Blood-Thinning Medications” (“Anticoagulants”) are medications which include “Dabigatran” (“Pradaxa”), Rivaroxaban” (“Xarelto”), “Apixaban” (“Eliquis”) and “Edoxaban” (“Savaysa”). They're shorter acting than “Warfarin” and usually don't require regular blood tests or monitoring by your Doctor. These drugs are also associated with a lower risk of “Bleeding Complications”.


“Stroke” is a potentially “Life Changing” event that can have long lasting “Physical” and “Emotional” Effects.

Successful recovery from a “Stroke” will often involve adopting certain specific Therapies and Support Systems, including:

(1) Speech Therapy

This helps with problems producing or understanding speech. Practice, relaxation, and changing communication style can all make communicating easier.

(2) Physical Therapy

This can help a person re-learn movement and coordination. It is important to stay active, even though this may be difficult at first.

(3) Occupational Therapy

This can help a person improve their ability to carry out daily activities, such as bathing, cooking, dressing, eating, reading, and writing.

(4) Support Groups

Joining a “Support Group” can help a person cope with common “Mental Health” issues that can occur after a “Stroke”, such as “Depression”. Many find it useful to share common experiences and exchange information.

(5) Support from Friends and Family

Close friends and relatives should try to offer practical support and comfort after a “Stroke”. Letting friends and family know what they can do to help is very important.

Rehabilitation is an important and ongoing part of “Stroke” treatment. With the right assistance and the support of loved ones, regaining a normal quality of life is usually possible, depending on the severity of the “Stroke”.

Learning the acronym “F.A.S.T” is a good way to remember the symptoms of “Stroke”. This can help a person seek prompt treatment. “F.A.S.T” stands for:

(1) Face Drooping

If the person tries to smile, does one side of their face droop?

(2) Arm Weakness

If the person tries to raise both their arms, does one arm drift downward?

(3) Speech Difficulty

If the person tries to repeat a simple phrase, is their speech slurred or unusual?

(4) Time to Act

If any of these symptoms are occurring, contact the Emergency Servicesimmediately.

The outcome depends on how quickly someone receives treatment. Prompt care also means that they would be less likely to experience “Permanent Brain Damage” or “Death”.


Our FU KANG TCM WELLNESS “Specialist Team” comprising of our TCM Physician, MISS JULI CHEE, working together with our Consultant Therapist, MR. SIM CHIN SENG has developed an unique Stroke Rehabilitative Treatment Therapy Program which is specially customised and tailored according to the Individual’s Post Stroke condition with the aim to “REVIVE”, “REJUVENATE” and “RESTORE” the Muscles, Nerves, that are responsible for the Movement and Mobility of the Body and Limbs to as close and as Normal to their Pre-Stroke condition. No two single treatments are the same as each individual Patient’s Post-Stroke conditions varies due to the different degree of severity of the Stroke they each suffered.

While every individual’s outcome and result may vary from patient-to-patient (depending upon the severity) of the “Stroke” and the “Damages sustained by the individual, overall improvements in “Mobility” and the “Quality of Life” have been vastly reported by the patients. The earlier you embark on the Stroke Rehabilitative Treatment Therapy Program, the higher your chances of regaining a higher degree of success and outcomes.

Call us to make an appointment to start your Stroke Rehabilitative Treatment Therapy Program as soon as possible, especially if you had already been on other Treatment Programs and have yet to see any tangible results or improvement to your current conditions after Months or even Years of Treatment. Many of our Treatment Techniques are unique only to us as some of these procedures were personally developed and pioneered by our own in-house Specialists themselves and are not used or practiced anywhere else in any other TCM Clinics or Western medical facilities.

Call us at 69834964 to book your Appointments. Currently, this Stroke Rehabilitative Treatment Therapy Program is only available on Thursdays only until further notice.

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