Types:
Hydrocephalus is said to be 'communicating' if the obstruction is outside the ventricular system (usually in the basal cisterns).
Obstruction within the ventricles is most common in the narrow channels of the third ventricle and aqueduct, and may be caused by tumour or a congenital anomaly such as aqueduct stenosis
CAUSES OF HYDROCEPHALUS
Communicating (obstruction outside ventricular system)
• Bacterial meningitis (especially tuberculous)
• Sarcoidosis
• Sub arachnoid haemorrhage
• Head injury
• Idiopathic (normal pressure)
Non-communicating (obstruction within ventricular system)
• Tumours
• Colloid cyst
• Arnold-Chiari malformation
• Aqueduct stenosis
• Cerebellar abscess
• Cerebellar or brain-stem haematoma
Clinical features:
This usually occurs as the congenital abnormality
The infant is born with a very large head , and the survival rate of the child is very low
Even if the child survives he is sustained with mental retardation and late milestone developnment
Investigations:
• Routine hematology investigations
• CSF fluid examination
• Lumbar puncture for fluid examination
• CT scan of brain
• MRI scan of brain
Homoeopathic approach:
Calcarea phosphorica:
Indicated in children with a pale or sallow face; the ears and nose are cold, there is retarded dentition.
The stools are loose,green and slimy and there is a constant desire to nurse; children crave potatoes and starchy food, or salt meat.
Calcarea carbonica finds its place in the early stage of acute hydrocephalus when Belladonna does not act; the abdomen is distended, the limbs wastes; there is sweating of the head during sleep; weak memory.
It suits best lively, precocious, large-headed children,whose bowels are inclined to looseness; frequent screaming without cause.
Helleborus:
This remedy suits apathetic cases when torpor predominates, unconscious, with the cephalic cry; the urine is suppressed and the eyes do not react the light.
There is an automatic motion of one-half of the body; the forehead muscles are corrugated and there is a constant chewing motion of the mouth; the patient is thirsty and drinks with avidity when drink is offered.
Helleborus corresponds to the stage of serous effusion; the sleep is soporous and interrupted by screaming spells.
Censorial apathy or the period of beginning paralysis marks the remedy.
Apis mellifica:
The child bores the head into the pillow and rolls it from side to side Apis will be the remedy.
Every little while he arouses with a shrill, piercing cry; this is due to the pain; one-half of the body is convulsed, the other half paralyzed; there is strabismus, rapid and weak pulse and scanty urine.
It is a slow acting remedy and its favorable action is shown by an increase of urine.
The child is very drowsy and the accumulation of fluid in the brain is very rapid.
Zincum:
The patient rolls head and wakes from sleep as if frightened; the occiput it hot, the forehead cool; there is grinding of the teeth; the eyes are sensitive to light, fixed and staring; the nose is dry.
There is jerking of muscles during the sleep, and a fidgety motion of the feet; the head is enlarged, with a sense of great outward pressure.
The child is weak and cold, bores head into pillow , cries out.
It is great remedy for the non-development of a disease.
Sulphur:
Then symptoms of stupor , cold sweat, jerking of limbs, spasms of the big toes, suppressed urine.
If from retrocessed eruptions it becomes all the more indicated.
The eyes are half open and the head falls backwards.
It is most suitable to the hereditary form.
Iodine :
It suits glandular subjects, tubercular form.
Darting pains in head, redness of face; dry, hacking cough,
worse at night; scrofulous constitutions are the special indications.
Silicea:
Head large, sweat on whole head rather than on scalp alone, sudden startings in sleep, sour eructations, redness of face, cold hands and feet will well indicate Silicea.
Baryta carbonica:
Large head, thin, scrawny neck, scrofulous diathesis, child does not want to play, tendency to glandular enlargements, hacking cough, emaciations are the special indicating symptoms of this remedy.
Apocynum:
It corresponds to the stage of exudation; the head is large and there is bulging of frontal bones; the fontanelles are open; there is squinting, paralysis, but no cephalic cry.