Acute Intracranial Hemorrhage Caused by Acupuncture

Source: Choo DC, Yue G. Acute intracranial hemorrhage caused by acupuncture. Headache 2000;40:397-398.

Context: Acupuncture is a traditional form of therapy in Asia for various illnesses, and in particular, for pain relief. It is gaining acceptance as an alternative therapy in Western countries. There are serious adverse affects of acupuncture reported in the literature including pneumothorax, hepatitis, and endocarditis.

Case Report: A report from the Department of Medicine at Loma Linda University in Southern California cites the case of a 44-year-old Chinese man who presented with a severe headache. The patient experienced sudden onset of severe occipital headache minutes after the insertion of an acupuncture needle at the "feng fu" trigger point. This point is located 3 cm below the external occipital protuberance. The acupuncturist re-moved the needle after the onset of the severe headache. There were no other neurological symptoms. The patient presented to the emergency department seven hours after the onset of headache. Physical exam was negative with the exception of nuchal rigidity and a positive Kernig sign. Immediate noncontrast computed tomography (CT) scan of the head showed hemorrhage in the fourth ventricle and small amounts of blood in the third and frontal horns of the lateral ventricles. Lumbar puncture revealed bloody fluid in all three tubes.

The patient was admitted for observation and pain management. For the next 28 days the severe occipital headache required opioids initially and acetaminophen subsequently to control the pain. A repeat CT scan 10 days later showed complete resolution of the hemorrhage. In a five-month follow-up visit, the patient’s headache and nuchal rigidity were completely resolved and he was back at work.

Comment: Although this report depicts a rare complication, complications of acupuncture can and do occur. In this instance, needle insertion caused acute subarachnoid and intracranial hemorrhage. Therapists who perform acupuncture and patients who receive it should be aware that the technique is not risk free. Adequate medical facilities need to be nearby to manage potential complications.