Head distension, commonly known as "brain distension."

This condition is similar to heaviness of the head. Heaviness of the head feels as if something is wrapping around it, causing a sensation of weight; head distension, on the other hand, feels as if the head is swelling and about to burst.

If head distension is occasionally caused by lack of sleep or drunkenness, it is not pathological and does not fall within the scope of this discussion.

bubble_chart Pattern Analysis

1. Up-flaming of Liver Fire︰It often arises from anger, with symptoms such as distending headache, dizziness, oppressive heat, prominent head veins, dry mouth, bitter taste in mouth, and in severe cases, sudden deafness. The tongue coating is thin and yellow, and the pulse manifestation is wiry or rapid. This condition is mostly caused by anger or emotional stagnation, leading to impaired free flow of liver qi, which stagnates and transforms into fire. Alternatively, excessive consumption of spicy foods may trigger upward rebellion of liver fire, disturbing the clear orifices and causing head distension. In severe cases, the seven orifices may become blocked, resulting in sudden deafness. Symptoms include distending headache, hypochondriac distending pain, dry mouth, bitter taste in mouth, irritability, thin yellow tongue coating, and wiry rapid pulse, all of which are signs of exuberant liver fire. The treatment principle is to clear the liver and drain fire, using Gentian Liver-Draining Decoction with modifications.
2. Damp Phlegm︰The head feels distended and heavy, as if wrapped by something, with chest tightness and epigastric fullness, abdominal distension and fullness, nausea, loss of appetite, and limb heaviness. The tongue coating is white and greasy, and the pulse is soggy or slippery. This is often caused by prolonged weakness in damp environments, exposure to rain or water, or invasion by dampness pathogens, leading to dampness obstruction and yang constraint, where clear yang fails to ascend and turbid yin fails to descend, resulting in head distension. Symptoms include a heavy, distended head as if tightly wrapped by cloth, epigastric fullness, nausea, a white and greasy tongue coating, and a soggy or slippery pulse—all signs of dampness obstruction. Treatment should focus on dispelling dampness and lifting the clear, using Atractylodes Rhizome Dampness-Resolving Decoction or Zhen-Clearing Decoction. This syndrome differs from head distension due to liver fire in both etiology and clinical manifestations. The former often exhibits signs of liver depression transforming into fire, while the latter is marked by internal obstruction of dampness turbidity, allowing for clear differentiation.

bubble_chart Documentation

1. 《Songya Zunsheng Shu．headache》: "Retained food not digested, fullness leads to turbid qi steaming upwards, causing head distension and pain, Stomach-Calming Powder with Immature Orange Fruit as the main ingredient."
2. Linzheng Zhinan Yi'an．liver wind: "Pulse is wiry on the right, head distension, tinnitus, and fire rising, this is liver yang stagnation, seven orifices malfunctioning."