Hydrocephalus and Homoeopathy

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Hydrocephalus and

Homoeopathy

Dr. Rajneesh Kumar Sharma MD (Homoeopathy)


Dr. Swati Vishnoi BHMS
Dr. Preetika Lakhera BHMS
Dr. Mohammad Tayyab Daud BHMS
Dr. Mohammad Tayyab Amir BHMS
Dr. Vaishnavi Rathore BHMS
Hydrocephalus and Homoeopathy

Hydrocephalus and
Homoeopathy
Dr. Rajneesh Kumar Sharma MD (Homoeopathy)
Dr. Swati Vishnoi BHMS
Dr. Preetika Lakhera BHMS
Dr. Mohammad Tayyab Daud BHMS
Dr. Mohammad Tayyab Amir BHMS
Dr. Vaishnavi Rathore BHMS
Homoeo Cure Research Institute
NH 74- Moradabad Road
Kashipur (UTTARANCHAL) - INDIA
Ph- 09897618594
E. mail- [email protected]
www.treatmenthomeopathy.com
www.homeopathyworldcommunity.com

Contents
Definition............................................................................................................... 2
Etymology.............................................................................................................. 2
Etiology.................................................................................................................. 2
Pathophysiology..................................................................................................... 3
Production of CSF............................................................................................... 3
Flow of CSF......................................................................................................... 3
Reabsorption of CSF........................................................................................... 4
Functions of CSF................................................................................................. 4
Types..................................................................................................................... 5
Congenital.......................................................................................................... 5
Acquired............................................................................................................. 5
Elevated pressure hydrocephalus.......................................................................5
Communicating or non-obstructive hydrocephalus.........................................5
Non-communicating or obstructive hydrocephalus.........................................5
Normal pressure hydrocephalus.........................................................................6
Infantile hydrocephalus...................................................................................... 6
Post-hemorrhagic hydrocephalus.......................................................................6
Post-infectious hydrocephalus............................................................................ 6
Hydrocephalus associated with MMC..................................................................6
Hydrocephalus associated with brain tumors.....................................................6
Signs and Symptoms............................................................................................. 6
Signs and symptoms of elevated-pressure hydrocephalus.................................6
Signs and symptoms of normal-pressure hydrocephalus....................................7

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Hydrocephalus and Homoeopathy

Cognition............................................................................................................ 7
Attention............................................................................................................. 7
Motor function.................................................................................................... 7
Epilepsy.............................................................................................................. 7
Vision.................................................................................................................. 7
Other associated problems.................................................................................8
Special problems in children with MMC..............................................................8
Diagnosis............................................................................................................... 8
Ultrasonography................................................................................................. 8
Computed tomography (CT)...............................................................................8
Magnetic resonance imaging (MRI)....................................................................8
Treatment.............................................................................................................. 9
CSF Shunt........................................................................................................... 9
Ventriculostomy.................................................................................................. 9
Homoeopathic remedies for Hydrocephalus.......................................................9
Short repertory of Hydrocephalus.....................................................................10
Bibliography......................................................................................................... 11

Definition
Hydrocephalus is a clinical entity in which a disturbance in the circulation of the
cerebrospinal fluid (CSF) (Psora) causes the accumulation of intraventricular CSF,
resulting in progressive ventricular dilation, characterized by increased
intracranial pressure, increased CSF volume and the dilation of the CSF spaces
(Sycosis).

Etymology
Greek hudro- water + kephal head = hudrokephalon
Late 17th century- modern Latin- Hydrocephalus
Hippocrates (466-377BC)- first described hydrocephalus
Early and medieval physicians- believed that the disease was caused by
the extra cerebral accumulation of water

Etiology
Hydrocephalus has a variety of causes including:

Congenital brain defects (Syphilis)


Hemorrhage, either into the ventricles or the subarachnoid space (Psora/
Syphilis)
Infection of the central nervous system like syphilis, herpes, meningitis,
encephalitis, or mumps (Psora/ Syphilis/ Sycosis)
Tumor (Psora/ Syphilis/ Sycosis)

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Hydrocephalus and Homoeopathy

Pathophysiology
Mechanism of CSF production and its flow runs as below-

Production of CSF
CSF is produced by the epidermal cells in choroid plexus of the lateral,
third and fourth ventricles
Rate of CSF production is approximately 10 ml per hour or 200-250 ml a
day in a small child, and in adolescents- about 20 ml an hour or 400-500
ml per day
The total CSF volume depends on the age of the person and is about 5 ml
in a newborn and reaches the adult volume of 80-150 ml at the age of
about five years

Flow of CSF
The CSF flows through the third ventricle and the cerebral aqueduct to the
fourth ventricle and through the foramen of Magendie and the lateral
foramina of Luschka into the subarachnoid space
The narrowest passage in the ventricular system is the cerebral aqueduct
or the aqueduct of Sylvius
The CSF flows around the tentorium

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Hydrocephalus and Homoeopathy

Reabsorption of CSF
CSF is re-absorbed into the venous system through arachnoid villi into the
sagittal sinus
Some of it flows down towards the lumbar subarachnoid space and re-
absorbed from the spinal canal as well

Functions of CSF
The CSF protects the brain and spinal cord, regulates the intracranial
pressure (ICP) within physiological limits and regulates the extracellular
environment in the brain
The physiological mechanism underlying hydrocephalus is-

An obstruction of the CSF circulation


Reduced re-absorption
In a few cases, the overproduction of CSF

The ventricular expansion displaces the surface of the brain and compresses the
cortical veins, leading to venous congestion and a subsequent increase in ICP.
The expansion of the ventricles also affects the surrounding brain structures and

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Hydrocephalus and Homoeopathy

the increase in ICP may cause cerebral edema affecting the white matter and
eventually also the grey matter.

Many maturational processes are affected in a negative way. These include-

The myelination process during which protective sheaths are formed


around axons. This is vital for the function of the brain and is negatively
affected by the increase in ICP in hydrocephalus.
The white matter, especially in the periventricular region, is affected by
compression and this is more obvious in young children than in older
persons.
There is also a thinning of the corpus callosum and of the cerebral cortex.
The reduction in the corpus callosum and the internal capsule is of specific
importance for cognition.

Types
Hydrocephalus can be classified into two forms-

Congenital
An obstruction of the cerebral aqueduct (aqueductal stenosis) is the most
frequent cause of congenital hydrocephalus. (Syphilis)

Acquired
Acquired hydrocephalus may result from spina bifida, intraventricular
hemorrhage, meningitis, head trauma, tumors, and cysts. (Psora/ Syphilis/
Sycosis)

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Hydrocephalus and Homoeopathy

Other way of classification keeps hydrocephalus in two headings-

Elevated pressure hydrocephalus


This type of hydrocephalus leads to an elevation of the CSF pressure within the
brain. This increased pressure pushes aside the soft tissues of the brain and
squeezes or distorts them, causing damage to these tissues. (Psora/ Sycosis)
In infants whose skull bones have not yet fused, the intracranial pressure is
partly relieved by expansion of the skull, so that symptoms may not be as
dramatic. This type of elevated-pressure hydrocephalus may occur from infancy
to adulthood and may be of two types-

Communicating or non-obstructive hydrocephalus


Whenever, there is a reduction in the absorption rate, caused by damage to the
absorptive tissue, the ventricles get turgid and the condition is called
communicating or non-obstructive hydrocephalus. (Psora/ Syphilis)

Non-communicating or obstructive hydrocephalus


This is the most common variety. There is a free flow of CSF from the ventricles
through the aqueduct and foramina to the spinal compartment. In this case,
reduced absorption occurs when one or more passages connecting the ventricles
become blocked. This prevents the movement of CSF to its drainage sites in the
subarachnoid space just inside the skull. (Psora/ Syphilis)
Thus, obstructive hydrocephalus is developed by the processes restricting the
intraventricular CSF flow leading to an increased amount of CSF not being
absorbed and resulting in enlarged ventricles.
Dandy says that almost every kind of hydrocephalus could be called obstructive,
as it is the CSF absorption that is obstructed in communicating hydrocephalus.
Several mechanisms lead to the obstruction of the CSF flow-

Primary malformations (Syphilis)


Hemorrhages (Psora/ Syphilis)
Post-infectious scarring (Psora/ Syphilis/ Sycosis)

Normal pressure hydrocephalus


It is marked by ventricle enlargement without an apparent increase in CSF
pressure and affects mainly the elderly.
Other classification of hydrocephalus may be as below-

Infantile hydrocephalus
This type of hydrocephalus is not associated with myelomeningocele (MMC) or
with malignant tumors and developing during the first year of life. Different
malformations such as Dandy-Walker, X-linked hydrocephalus, arachnoidal cysts
and aqueductal stenosis belong to this group. (Psora/ Syphilis/ Sycosis)

Post-hemorrhagic hydrocephalus
Arachnoiditis is caused by the blood and hemorrhagic debris in the ventricles
that most often obliterates the posterior fossa or the aqueduct of Sylvius. (Psora/
Sycosis)

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Hydrocephalus and Homoeopathy

Post-infectious hydrocephalus
Obstructions in various parts of the CSF pathways by infections and scarring may
result in increased intracranial pressure and hydrocephalus. (Psora/ Syphilis/
Sycosis)

Hydrocephalus associated with MMC


Several factors are important for the pathogenesis of this type of hydrocephalus-

The Arnold-Chiari type II malformation with an abnormal disposition of the


brain stem, a deformity of the posterior fossa, where the cerebellar tonsils
prolapse through the foramen magnum and the fourth ventricle is
displaced. (Syphilis)
Aqueductal stenosis as a consequence of the Arnold-Chiari II malformation
(Syphilis)
Distal tethering of the spinal cord in the MMC, displacing posterior fossa
structures downwards (Psora/ Syphilis/ Sycosis)

Hydrocephalus associated with brain tumors


Hydrocephalus may be associated with malignant tumors in the posterior fossa.
(Psora/ Syphilis/ Sycosis)

Signs and Symptoms


Signs and symptoms of elevated-pressure hydrocephalus
Headache
Nausea and vomiting, worse in the morning
Lethargy
Disturbances in gait
Diplopia
Subtle difficulties in learning and memory
Delayed developmental milestones

Irritability is the most common sign of hydrocephalus in infants. If this is not


treated, it may lead to lethargy.
Bulging of the fontanelles, or the soft spots between the skull bones, may also be
an early sign. When hydrocephalus occurs in infants, fusion of the skull bones is
prevented. This leads to abnormal expansion of the skull.

Signs and symptoms of normal-pressure hydrocephalus


Dementia
gait abnormalities
incontinence of urination or bowel movements

Hydrocephalus is a complex disorder with a significant impact on the brain not


only macroscopically but also it affects the physiology, biochemistry and on the
ultrastructure of the brain.
The macroscopic changes lead to the distortion of structures, such as the
compression of white and grey matter, causing compression of cerebral blood
vessels leading to reduction of the cerebral blood perfusion. These changes are
important for the severity of the consequences of hydrocephalus. The outcome
of hydrocephalus may be-

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Hydrocephalus and Homoeopathy

Cognition
The intellectual performance is affected even if the hydrocephalus is
treated and the overall IQ is in the low-average range or below
The verbal intelligence is often better preserved than the non-verbal
There may be problems with visual perception, visuo-construction, visuo-
orientation and recognition of faces
Executive functions such as planning, organization and using strategies
may also be impaired

Attention
Early-onset hydrocephalus is frequently associated with behavioral
problems
Autism disorders are common
Some children with hydrocephalus had deficits in selective and focused
attention
Children with MMC have been found to be more easily distracted and
inattentive than controls

Motor function
Motor impairments are common
Musculoskeletal dysfunction is common even in post-surgical cases
The etiology and gestational age at birth have an important effect on the
severity of the motor disability.
Many children born preterm with hydrocephalus after a perinatal cerebral
hemorrhage develop cerebral palsy
In children with MMC, the motor function is dependent on the spinal lesion
and about half these children learn to walk, with or without aid

Epilepsy
Children with hydrocephalus often have a convulsive disorder
The etiology of the hydrocephalus and the presence of neuroradiological
abnormalities in the brain parenchyma have an important impact on the
risk of developing epilepsy
In some studies, the presence of a shunt appears to increase the risk of
developing seizures
Most of the seizures are of the partial type and involvement of the side
contralateral to the shunt placement

Vision
The dilation of the ventricles and the increase in ICP can cause damage to
the occulomotor pathways, the optic nerves and the optic radiation
This is the cause why patients of hydrocephalus may have visual
impairments
The posterior visual pathways are close to the lateral ventricles and may
be damaged by the dilation of the ventricles
Optic atrophy can result from the traction or compression of the optic
nerve
Other visual impairments, such as reduced visual acuity, visual field
defects and strabismus, visual perceptual problems have been described
in several studies

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Hydrocephalus and Homoeopathy

Other associated problems


Some children develop precocious puberty
Recurring periods of headache, nausea and somnolence are not
uncommon

Special problems in children with MMC


Children with MMC have a complex situation and as a consequence of the spinal
lesion, they have a variety of problems apart from the hydrocephalus-

Neurogenic bladder and bowel dysfunction


Motor impairment is often prominent and many deteriorate as they grow
up
About half the children manage to walk by themselves, some with aid
Upper limb function is also frequently affected
They often develop scoliosis and there is a risk of progressive neurological
symptoms due to the tethered cord syndrome

Diagnosis
The primary diagnosis is made by looking at size of head and by case taking
thoroughly. The hydrocephalus is easy to diagnose.
Its diagnosis is based on the analysis of the size of the ventricles. The ventricles
can also be enlarged due to atrophy of the brain and this condition has to be
distinguished from hydrocephalus.
In infants with open sutures, the diagnosis can be made clinically by measuring
an increase in head circumference. In older children with closed sutures, there is
a compression of the peripheral CSF spaces, which can be confirmed by
neuroimaging.

Ultrasonography
This is the screening procedure in small children when the anterior fontanel is
still open. It can also be useful for follow-up after treatment to check the
ventricular size.

Computed tomography (CT)


CT is excellent for analyzing the sizes of the ventricles and, when the ventricles
are enlarged, to distinguish hydrocephalus from atrophy.
After shunting, a CT scan is often sufficient as a follow-up investigation.

Magnetic resonance imaging (MRI)


This is the best way and to some extent, it can also visualize the CSF flow to
investigate the patency of the aqueduct or after ETV.

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Hydrocephalus and Homoeopathy

Treatment
CSF Shunt
The insertion of a CSF shunt is a common procedure. The equipment that is used
is a proximal catheter, which usually has several openings. The catheter is
placed in the ventricle that is going to be drained. Shunts often fail because the
catheter is occluded by some tissue.

Ventriculostomy
The principle is to perform a stoma in the bottom of the third ventricle and from
there lead the CSF to the subarachnoid spaces where it can be re-absorbed.

Homoeopathic remedies for Hydrocephalus


Since hydrocephalus affects the higher centers of an individual, the entire
organism is affected. The only way of treatment becomes the holistic one. If
studied carefully and logically, the similimum remedy can be found and the case
may be cured easily. Of course, the causa ocassionalis or maintaining cause is to
be removed first.
The following Homoeopathic remedies are wonderful in curing hydrocephalus,
but if used as per laws of Homoeopathy-

Dr. Rajneesh Kumar Sharma MD (Homoeopathy) 8


Hydrocephalus and Homoeopathy

abrot. acon. agar. am-c. APIS apoc. Arg-n. Arn. ars-i. Ars. Art-v. atro-s. aur-ar. aur-
s. Aur. Bac. bar-c. bell. Bism. Bry. cadm-s. calc-i. Calc-p. calc-sil. CALC. CAMPH.
canth. Carb-ac. caust. Chin. chinin-s. Cina Clem. coloc. Con. crot-h. cupr-act.
cupr. cypr. cyt-l. Dig. ferr-i. Ferr. galv. gels. Grat. hed. Hell. Hyos. ign. indg. Iod.
iodof. Ip. kali-br. Kali-i. kali-p. lach. LYC. mag-m. Merc. Nat-m. nux-v. oeno. Op. ph-
ac. Phos. plat. podo. Puls. rhus-t. samb. sep. SIL. sol-ni. spig. squil. Stram. Sulph.
thuj. toxo-g. tub. verat-v. Verat. viol-t. zinc-br. Zinc-m. Zinc.

Short repertory of Hydrocephalus


FACE - COLDNESS - hydrocephalus, in agar. arg-n. CAMPH. hell. Lyc. Verat.
GENERALS - CONVULSIONS - hydrocephalus; with Arg-n. Art-v. bell. Calc. hell.
Kali-i. Merc. Nat-m. Stram. Sulph. Zinc.
GENERALS - HISTORY; personal - hydrocephalic children; of delivering calc-p.
HEAD HYDROCEPHALOID phos. Zinc.
HEAD - HYDROCEPHALUS - accompanied by - blindnessapoc.
HEAD - HYDROCEPHALUS - accompanied by - Neck; emaciated calc-p.
HEAD - HYDROCEPHALUS - accompanied by - weakness; general sil.
HEAD - HYDROCEPHALUS - acute - measles; after merc.
HEAD - HYDROCEPHALUS acute apoc. cupr. cyt-l. hell. merc. op.
HEAD - HYDROCEPHALUS - beginning stage toxo-g.
HEAD - HYDROCEPHALUS - cholera; after - children; in zinc.
HEAD - HYDROCEPHALUS chronic art-v. calc-i. calc-p. hed. kali-i. op. zinc.
HEAD - HYDROCEPHALUS - diarrhea agg.; after - children; in zinc.
HEAD - HYDROCEPHALUS - diarrhea agg.; after - long, exhausting diarrhea cypr.
HEAD - HYDROCEPHALUS edematous hell.
HEAD - HYDROCEPHALUS - lies with head low apis merc. sulph. zinc.
HEAD - HYDROCEPHALUS - meningitis; after apis sol-ni. sulph. tub.
HEAD - HYDROCEPHALUS - perspiration; with merc.
HEAD - HYDROCEPHALUS - scarlatina; after apis merc.
HEAD HYDROCEPHALUS abrot. acon. am-c. APIS apoc. arg-n. Arn. ars-i. Ars. art-
v. atro-s. aur-ar. aur-s. Aur. Bac. bar-c. bell. Bism. Bry. cadm-s. calc-i. Calc-p. calc-
sil. CALC. canth. carb-ac. caust. Chin. chinin-s. cina coloc. Con. crot-h. cupr-act.
cupr. cypr. cyt-l. Dig. ferr-i. Ferr. galv. gels. grat. Hell. Hyos. ign. indg. Iod. iodof.
Ip. kali-br. Kali-i. kali-p. lach. LYC. mag-m. Merc. Nat-m. nux-v. oeno. Op. ph-ac.
Phos. plat. podo. Puls. rhus-t. samb. sep. SIL. sol-ni. spig. squil. Stram. Sulph.
thuj. toxo-g. tub. verat-v. verat. viol-t. zinc-br. Zinc-m. zinc.
MIND - EXCITEMENT - hydrocephalus, in Apis Carb-ac.
MIND - FEAR - hydrocephalus, in Zinc.

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Hydrocephalus and Homoeopathy

MIND - SHRIEKING - hydrocephalus, in APIS Cina Dig. kali-i. Lyc. merc. Zinc.
MIND - STUPOR - hydrocephalus, in APIS Apoc. Clem. Hell. Hyos. Lyc. Nat-m.
MIND - UNCONSCIOUSNESS - hydrocephalus, in APIS apoc. art-v. Clem. Grat. Hell.
Hyos. Lyc. Nat-m.
RECTUM - DIARRHEA - hydrocephalus acutus, during Apis bell. Calc. Carb-ac.
Hell. Zinc.
URINE - MILKY - hydrocephalus; in - little but frequent discharges of milky urine;
with very - unconsciousness and delirium; with APIS
URINE - MILKY - hydrocephalus; in Apis

Bibliography

Atlas of Clinical Manifestations of Metabolic Diseases > INTRODUCTION


Harrison's Principles of Internal Medicine..., at which time he had developmental
delay, hepatomegaly, and skeletal involvement. At the time of the picture, the
patient had short stature, an enlarged tongue, persistent nasal discharge, stiff
joints, and hydrocephalus. Verbal language skills consisted of four or five words.
The patient had a severe...

Cestode Infections > Clinical Manifestations Harrison's Principles of Internal


Medicine... FIGURE 260-1 Neurocysticercosis is caused by Taenia solium.
Neurologic infection can be classified on the basis of the location and viability of
the parasites. When the parasites are in the ventricles, they often cause
obstructive hydrocephalus. Left: Magnetic resonance imaging...

Chapter 17. Coma and Related Disorders of Consciousness > Acute


Hydrocephalus Adams & Victor's Principles of Neurology, 10e... The syndrome of
acute hydrocephalus, most often from subarachnoid hemorrhage or from
obstruction of the ventricular system by a tumor in the posterior fossa, induces a
state of abulia (slowed responsivity), followed by stupor, and then coma with
bilateral Babinski signs. The pupils are small...

Chapter 232. Normal Pressure Hydrocephalus The Color Atlas of Family


Medicine, 2e

Chapter 30. Disturbances of Cerebrospinal Fluid, Including Hydrocephalus,


Pseudotumor Cerebri, and Low-Pressure Syndromes > Neuropathologic Effects of
Hydrocephalus Adams & Victor's Principles of Neurology, 10e... Ventricular
expansion tends to be maximal in the frontal horns, explaining the hydrocephalic
impairment of frontal lobe functions and of basal ganglionicfrontal motor and

Dr. Rajneesh Kumar Sharma MD (Homoeopathy) 8


Hydrocephalus and Homoeopathy

gait activity in most forms of hydrocephalus. The central white matter yields to
pressure, while the cortical gray matter...

Chapter 34. Cerebrovascular Diseases > Hydrocephalus Adams & Victor's


Principles of neurology, 10e... If a large amount of blood ruptures into the
ventricular system or floods the basal subarachnoid space, it may find its way
into the ventricles through the foramina of Luschka and Magendie. The patient
then becomes confused or unconscious as a result of acute hydrocephalus . The
clinical signs...

Chapter 35. Craniocerebral Trauma > Posttraumatic Hydrocephalus Adams


& Victor's principles of Neurology, 10e... This is an uncommon complication, but
one that is frequently imputed to severe head injury. It conforms to the category
of normal pressure hydrocephalus, as discussed in Chap. 30 . Intermittent
headaches, vomiting, confusion, and drowsiness are the initial manifestations.
Later on, mental...

Encyclopedia Homoeopathica

Neurosurgery > Hydrocephalus Schwartz's Principles of Surgery, 10e...


(contrast to Fig. 42-2 ). The patient had normal-pressure hydrocephalus and had
improved ambulation after placement of a ventriculoperitoneal shunt. B . Higher
cut from same scan showing ventricular catheter in place in the frontal horn of
the right lateral ventricle. Figure 42-33...

Pathology of the Nervous System > Hydrocephalus Pathology: A Modern


Case Study... TABLE 21-2 Common causes of hydrocephalus. Aqueductal stenosis
may result from a congenitally malformed cerebral aqueduct or from an
acquired stenosis DandyWalker malformation a hindbrain malformation
defined by the triad of (1) hypoplasia of the cerebellar...

Radar 10

Stroke Rehabilitation > D. Hydrocephalus CURRENT Diagnosis & Treatment:


Physical Medicine & Rehabilitation ... Hydrocephalus is an excessive
accumulation of cerebrospinal fluid within the ventricles or subarachnoid space,
or both, and often complicates subarachnoid hemorrhage (SAH), intracerebral
hemorrhage (ICH), and intraventricular hemorrhage (IVH). IVH, in particular, can
lead to arachnoiditis from...

Dr. Rajneesh Kumar Sharma MD (Homoeopathy) 8


Hydrocephalus and Homoeopathy

Traumatic Brain Injury > Elevated Intracranial Pressure & Hydrocephalus


CURRENT Diagnosis Treatment: Physical Medicine & Rehabilitation... edema,
craniectomy to increase the cranial volume, and drainage of the excess CSF. In
the postacute setting, hydrocephalus is common, but the interpretation of the
finding of ventricular dilation on head CT can be difficult. With more severe TBIs,
hydrocephalus ex vacuo may occur; this is an increase...

Dr. Rajneesh Kumar Sharma MD (Homoeopathy) 8

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