Angioneurotic headache is a paroxysmal violent distending headache due to disturbance of vascular diastolic and systolic functions. It belongs to the category of “headache" in traditional Chinese medicine (TCM) and often results from stagnation of the liver qi and deficiency of the kidney yin.  The author adopted acupuncture therapy to treat 80 cases of angioneurotic headache and achieved satisfactory therapeutic results. Here is the summary.    

General Data 
The present series of treatment were made up of 80 cases including 36 males and 44 females. The youngest was 16 years and the oldest 68 years. The shortest duration of disease was 12 days and the longest 36 years. 28 cases had a headache on the left side and 37 cases had a headache on the right side and 15 cases had a headache on both sides. At that time, 58 cases had received treatment with Western medicine or Chinese herb medicine. All the patients had a typical clinical  symptoms as repeated attack of headache, vascular undulatory feeling, insomnia, dreaminess, nausea, hypomnesis, etc.. Through neurological examination, no any space occupying lesion was found.    

Treatment Methods 
Acupoints selected were Fengchi (GB 20), Baihui (GV 20), Ashi point, Neiguan  (PC 6), Hegu (LI 4), combined with Taichong (LR 3) for stagnation of liver qi, or with Taixi (KI 3) for deficiency of kidney yin.

Operation: Asked the patient to take a sitting position. After routine sterilization, Fengchi (GB 20) was taken first, with the needle punctured straightly to a depth of about 1 cun. Lifted the needle rapidly and thrusted it slowly and repeatedly to get needling sensation. When the patient felt needling sensations spreading outwards, the needle was lifted a little bit and then advanced obliquely  towards the affected area about 0.5 cun deep. Ordered the patient to make slow deep respiration and controlled the needling sensations to spread towards the affected area. When the patient experienced stronger radiating needling sensation toward the deep part of the brain, the needle was retained for 30 min. 1-2 Ashi points, where a palpable cordlike muscle could be felt, were punctured transversely towards the pain direction to a depth of about 0.5-1 cun, with  the needle not manipulated. Neiguan (PC 6) and Taixi (KI 3) were punctured and stimulated with reinforcing method (gentle stimulation) while the other acupoints were stimulated with lifting, twirling and twirling method properly till the patient underwent obvious sore, numb, heavy and distending sensations in the topical part.  The needles were retained for 30 min. The treatment was given once daily, with 7 sessions being a therapeutic course and with 3 days' rest between two courses.    

Criteria for evaluating the therapeutic effect 
Cured: After treatment, the headache and its concurrent symptoms disappeared and had no any relapse within half a year.   Markedly effective: Headache disappeared but attacked again after a longer period of time. If treated again, the headache stopped immediately. 

Effective: After treatment, the headache was relieved considerably but had relapse frequently. 

Ineffective: After 2 courses of treatment, symptoms had no any apparent improvement in comparison with pretreatment.     

Results   
After 1-2 courses of treatment, of the 80 cases, 52 (65.0%) cases were cured, 14 (17.5%) markedly effective, 12 (15.0%) effective and 2 (2.5%) had no any effect.   

A typical case  
Mr Liu, aged 42 years, a teacher. His first visit was on May 7, 1998. Chief complaints were headache for more than 6 years with frequent attack within recent 3 months. He complained of having got a distending stabbing pain in the head, particularly at the forehead and on the left side 6 years ago, which worsened when he got tired or fell into mental stress due to over work. He often had concurrent insomnia and nausea. Cerebral CT examination had no any abnormal findings, it was diagnosed as angioneurotic headache by a Westernmedicine hospital  and treated with analgesics, oryzanol, vitamin B1, etc.. At that time of treatment, his situations got worse in spite of administration of the above mentioned medicine. He came to our hospital and asked for acupuncture treatment. After one treatment with the aforementioned acupoints, his headache was relieved significantly but still had a slight distending feeling in the head. He slept well during that night and his symptom of nausea disappeared. After successive 5 sessions o f treatment, his symptoms vanished completely and the followup in half a year  showed no relapse.   

Comments 
Angioneurotic headache is characterized as pain being violent during attack, stable in location and lingering in the course of disease. Modern medicine holds that it may be related to dysfunction of the relevant central nervous structure being in charge of regulation of vascular activity. It was called as “pian tou tong" (migraine) or “pian tou feng" (wind syndrome of head) in TCM and was considered to be related to dysfunction of the liver and kidney. TCM holds that the  head is the confluence site of all yang and the Liver Meridian goes up to the vertex of the head. If the liver is out of function in regulation of qi  flow, the accumulated qi will transform into fire to harass the head to induce headache. If the resultant fire injures yin, the liver loses enough nutrition, or if the  kidney water is consumed seriously, the water (kidney) will fail to nourish the wood (liver) and the liver yang will fall into hyperactivity. In such cases, the head will be disturbed to produce pain. In addition, headache also results from in sufficiency of the brain marrow and essential qi due to congenital defect and chronic consumption of the kidneyessence. Fengchi (GB 20) is the confluence point of the Foot Shaoyang and Foot Taiyang Meridians. When punctured, this point can  function in clearing away the accumulated heat in Shaoyang and expelling wind to relieve pain. Baihui (GV 20) belongs to Du Meridian and is in charge of all yang. Both Liver and Du Meridians gather at the vertex, when punctured, they can function in inducing refreshment and resuscitation, calming the liver to restrict exuberant yang. Neiguan (PC 6) is the crossing point of 8 meridians and serves to soothe the chest oppression, relieve the depressed liver, regulate qi and pro mote circulation of blood as well as tranquilize the mind. Hegu (LI 4) is one of  the “Siguan Points" (elbow joints and knee joints) and can function in relieving spasm, tranquilizing the mind and relieving pain. Taichong (LR 3) and Taixi ( KI 3) are the source points of the Liver Meridian and the Kidney Meridian respectively. The former point is used to lower the liverfire and suppress the reversed windyang; while the later point is employed to reinforce the kidney, enrich the essence and restrict the excited liveryang. All the above mentioned acupoints used together can regulate meridian qi, dredge meridians and relieve pain. As a result, all the symptoms were removed at last. 

By Guo Yunping, Ran Maodong, etc.