The Liver channel has a branch that goes directly to the top of the head. A couple of common cause for headaches in this area are Liver fire flaring or Liver yang rising. Vertex headaches can also be Bladder channel related. The Bladder meridian goes over the top of the head. Neck tension and pain can tighten the muscles along this meridian and tighten along the top of the scalp. Eye strain can cause this too, causing tension around the eyes at Bladder 2 and then translating up and over the top of the head.
If you diagnosis and differentiation confirm Liver or Bladder involvement, use these point combinations.
Liver involvement:
Bilateral needling Liver 3. Angle the needle like you are aiming for Ki 1.
Bladder channel involvement
Bilateral needling Bladder 65. Angle the needle like you are aiming for Ki 1.
Notes of caution: If you have a patient with recurrent head pain in the same area, send them for imaging and testing, as it could be something structural or tumor related. If they are in excruciating pain and say it's the worse headache they've ever had in their lives, send them to an emergency room.
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