In patients over 50 years old (smoking and long-term hypertension advance to 40 years old) if dizziness occurs, cerebral insufficiency of blood supply is the most common cause, while only a small percentage of those under 50 years old are cerebral insufficiency of blood supply (there should be smoking, heavy drinking, hypertension, diabetes, obesity, hyperlipidemia or hyperhomocysteine, vascular malformation and other risk factors one or several) (even if symptomatic and etiological treatment can only somewhat It is difficult to completely cut off the root of the problem, after all, the years are not forgiving). People over 40 years of age basically have cervical degeneration (cervical spine osteophytes, either mild or severe), and it so happens that most patients with dizziness are prone to dizziness or aggravated dizziness when they turn their head and neck from side to side or flex and extend. Therefore, I have noticed such a common clinical phenomenon: regardless of the cause of dizziness, regardless of age (some are in their 20s) and the presence of risk factors for cerebral blood supply deficiency, and without careful inquiry into the patient’s mood and sleep (one should also ask whether there was anything obviously unhappy or anxious before the illness), once the patient says that he or she is dizzy, the doctor can easily either classify the dizziness as cerebral blood supply deficiency and diagnose it as caused by cervical spondylosis Dizziness (insufficient blood supply to the brain due to compression of blood vessels or distortion). There is a 50-70% chance that such a diagnosis will be correct, while the remaining 20-25% may see a few more doctors and then the doctor will see that the dizziness is not due to cerebral insufficiency and consider that it is related to psychological factors (if no reasonable explanation is given, the patient’s compliance with the treatment will remain poor and affect the effectiveness of the treatment), and the last 5-10% will never be clearly diagnosed, so the patient will see a doctor everywhere and the cause will always be difficult to understand. Naturally, it is difficult to treat them in a pertinent and effective way. Some of them end up coming to see doctors in Beijing or to see me. The specific causes of cerebral insufficiency: There are many kinds, among which cerebral arteriosclerosis is only relatively common. There are also individual cases of cerebral insufficiency that have been identified with a specific cause, such as upright blood pressure drop, heart disease, low blood pressure due to long-term antihypertensive medication, anemia, high cranial pressure, etc. Other causes of cerebral hypoperfusion that are either strong or weak and can directly cause dizziness include: cerebral white matter degeneration, encephalitis, vestibular neuritis, vascular malformations, multiple system atrophy, or blood disorders, cervicogenic causes, hypoglycemia, methemoglobinemia, etc. Characteristics of cerebral insufficiency: Most of them are paroxysmal and transient, usually lasting for several days and relieved by themselves, or after infusion or oral medication. It is easily relieved by lying down for a period of time (minutes to days). There can be no precipitating factors. There can also be factors that can aggravate dizziness, such as: getting up quickly, turning the neck quickly, tilting the head, after urination, exertion, anxiety and anger, lack of sleep, etc. In individual cases, dizziness may be aggravated by any change in body or head position. The aging of the human body begins with arteriosclerosis, and all the arteries in the body are not immune to it, but the hardening of the brain and heart arteries is more obvious. 45 years old is the beginning of arteriosclerosis, after 50 years old, arteriosclerosis is manifested as a slight thickening of the intima of the arteries (i.e., a lack of blood supply to the brain), after 55-60 years old, intimal plaques begin to appear, and after 65-70 years old, most people will have universal arterial plaques. After the age of 75-80, the plaque increases to the extent that the arterial stenosis is greater than 50%, so after the age of 80, regardless of men and women are prone to cerebrovascular disease (cerebral infarction, cerebral hemorrhage), of course, after the age of 50, when the cerebral blood supply is insufficient, it is commonplace. However, the factors that cause dizziness after the age of 50-60 may be more complex, i.e., it may be a simple lack of cerebral blood supply, or it may be purely functional, or it may be a combination of the above two factors. It is sometimes difficult to distinguish which is primary and which is secondary, and sometimes experimental treatment is required. (Note: Apart from old age, smoking is the biggest risk factor for accelerated atherosclerosis. For example, if you smoke 1 pack of cigarettes a day, your blood vessels will age 10 years faster, 2 packs 15 years faster, and 3 packs 20 years faster. For example, if a person is 55 years old and smokes 1 pack of cigarettes a day, his blood vessels are equivalent to the quality of the blood vessels of a 65 year old non-smoking normal elderly person; if he smokes 2 packs of cigarettes a day, his blood vessels are equivalent to the blood vessels of a 75 year old non-smoking elderly person. I also observed that 90% of people who developed significant cerebral infarction before the age of 60 were either smokers or chronically hypertensive and naturally predominantly male.) Lesson learned A: In all cases where dizziness has been present for more than 3 months, if it is not significantly relieved by infusion of fluids for cerebral insufficiency, be sure to ask about the effect of posture on blood pressure and the possibility of other diseases. More importantly, we should ask whether there are angry, upset, anxious, anxious things before the disease, how is the mood? How is the quality of sleep, etc., and what is the usual personality? Simply put, we should take into account whether there are external adverse triggers and psychological factors such as the psychological quality of our own personality involved. Experience B: For a patient, especially those over 50 years of age, sometimes dizziness may be caused by a combination of factors, or one factor may be dominant, or it may be impossible to determine which factor is dominant and which factor is secondary, no matter how many tests are done. In this case, it depends on the doctor’s clinical experience and understanding, and it is necessary to experiment with segmental treatment or different treatment plans. Experience C: Regardless of whether the pathogenic factors can be clearly defined, sometimes some cases recover well with pertinent treatment, even if it is experimental allopathic treatment. However, there are many patients with dizziness who have been treated with multiple regimens, but the final outcome is often poor, because it is sometimes difficult or almost impossible to eliminate the factors that caused the dizziness, for example, especially atherosclerosis. Moreover, even if the dizziness improves at the moment, it is likely to recur in the future.