Wednesday 11 February 2015

A CASE OF CEREBROSPINAL FLUID LEAK



A CASE OF CEREBROSPINAL FLUID LEAK
One of my patient brought report (on 17.11.2014) of his friend’s wife which reads as –
Pt name – E N K
Age – 35 yrs                          Date- 14.11.2014
Ref. by – Dr. XYZ     MS DORL
C/O – Rt Nasal Watery Discharge since 28 days
About 1 cc of clear colorless fluid received
Fluid Sugar – 48 mg/dl
Conclusion: Possible CSF leak
She was advised for Cisternography at Mumbai. They had taken appointment of 18.11.2014.
My patient’s genuine concern was this pt should be cured by Homoeopathy and should have no need of Allopathy. So, he wanted me to give medicine even though patient was at her place.
While I was enquiring about patient’s complaint, he (my old pt) told that this discharge started 5 days after PUP in house fell down on pt’s head.
After that she had fever with soreness of body.
She is feeling irritated with this complaints. She says, “I am fed up know (Vaitagli)”.
With this data I had to prescribe her medicine which will fulfill my pts expectation from me.
(Sometimes situation come like this, that your pts have more confidence-cum-faith than you.)

Rubrics selected were:
MIND - IRRITABILITY - pain, during
MIND - DISGUST
GENERALS - INJURIES - traumatic fever
GENERALS - INJURIES - concussion
GENERALS - PAIN – sore
Result of Repertorization:
Arn – 11/5, Puls – 9/4, Ars – 8/4, Chin – 7/4, Sulph – 7/4
Arn 1m 3 doses were given with 15 min interval with placebo hrly
At Evening 5:30pm-
Slightly better
Next morning –
Much better but going to Mumbai as taken appointment for Cysternography.
19.11.2014 –
CT Cysternography report through fax:
Remarks – Intrathecal contrast leak from the right cribriform plate into the right middle, right anterior ethmoid sinuses; no major bony defect or fracture seen.
Corresponding inflammatory changes at ethmoid and right maxillary sinuses.
 They advised URGENT OPERATION as this may cause complications like Meningitis, Viral encephalitis etc. and patient will be critical and should be tackled within ICU. So, decide as early as possible.
At Evening (19.11.2014):
Patient herself came. NASAL DISCHARGE TOTALLY STOPPED but now sever headache > hard pressure, pain fro shoulder to neck to vertex++, Bandaging head tightly < jar, jerks
Back pain since Anesthesia Inj. By ENT
BP – 130/88
P/R – 64/min
Wt – 108 kg
Placebo 2 hrly continued.
 22.11.2014 –
Everything is fine except heaviness in head.
This heaviness of head took about 1 week to get settled.
This case proves efficacy of HOMOEOPATHY in emergency cases.