I. Hydrocephalus (hydrocephalus)
Hydrocephalus definition
Hydrocephalus is a condition in which the cerebrospinal fluid circulation and secretion and absorption are impaired, and excessive cerebrospinal fluid accumulates in the ventricles of the brain or in the subarachnoid space within the skull. Most often there is an increase in intracranial pressure. Infantile hydrocephalus is a common type of hydrocephalus, mostly occurring in infants less than two years old. In addition to unsteady gait and urinary incontinence, there is often mental decline or dementia.
Etiology of hydrocephalus
The pathological changes of hydrocephalus are the gradual enlargement of the ventricular system, the bulging of the third ventricle downward to compress the pituitary gland and the optic nerve cross section, and the thinning of the brain parenchyma, most obviously in the frontal lobe, even penetrating the lateral ventricle to connect with the subarachnoid space. The corpus callosum, pyramidal bundle, basal ganglia, tegmentum, choroid plexus and brainstem can be atrophied due to long-term compression. White matter demyelination, nerve axon compression and deformation, gliosis and degenerative neuronal cell degeneration are observed.
Hydrocephalus is a general term for an excess of cerebrospinal fluid and an increase in pressure due to a disorder in the process of cerebrospinal fluid production or circulation and absorption, which expands the space occupied by normal cerebrospinal fluid, resulting in an increase in cranial pressure and enlargement of the ventricles. Most of the causes are due to obstruction in some parts of the cerebrospinal fluid circulation pathway, while excess generation is less common. It occurs mostly in infants within two years of age, and can be divided into two categories: communicative and non-communicative hydrocephalus. Communicative refers to the obstruction of cerebrospinal fluid absorption on the surface of the brain; non-communicative refers to the obstruction of cerebrospinal fluid circulation within the ventricular system. There are many causes of hydrocephalus, and the common ones are as follows.
1) Congenital malformations: such as stenosis of the midbrain aqueduct, atresia malformation of the interventricular foramen (median foramen of the fourth ventricle or lateral hollow atresia), cerebrovascular malformation, spina bifida, and subhypophyseal herniation of the cerebellum.
2) Infection: Intrauterine infections such as various viral, protozoal and syphilitic spirochete infectious meningitis are not controlled early enough, and the proliferating fibrous tissue blocks the circulatory orifice of cerebrospinal fluid, or intracranial inflammation in the fetus may also occlude the cerebral pool, subarachnoid space and arachnoid granules with adhesions.
3) Hemorrhage: fibrous hyperplasia caused by intracranial hemorrhage, malabsorption of intracranial hemorrhage from birth injury, etc.
4) Tumor: can obstruct any part of the cerebrospinal fluid circulation, more commonly seen near the fourth ventricle, or choroid plexus papilloma.
(5) Other: certain hereditary metabolic diseases, perinatal and neonatal asphyxia, severe vitamin A deficiency, etc.
Clinical manifestations of hydrocephalus
The clinical findings are not consistent and are related to the age at which the pathological changes appear, the severity of the pathology, and the duration of the disease. Congenital hydrocephalus in the fetus mostly results in stillbirth. Hydrocephalus may appear at any age after birth, mostly in the first 6 months of life. In younger patients, the cranial sutures are not joined and the head is easily enlarged, so there are fewer symptoms of increased intracranial pressure. Hydrocephalus mainly manifests as a rapid, progressive enlargement of the infant’s head weeks or months after birth. The normal head circumference of newborns is 33-35 cm, the posterior fontanelle closes 6 weeks after birth, and the anterior fontanelle closes between 9 and 18 months, these data can be used as reference, the normal infant’s head circumference increases 1.2-1.3 cm per month in the earliest six months, this disease is 2-3 times, the skull is round, the frontal part protrudes, the fornix of the head is abnormally enlarged, the fontanelle expands and bulges, the cranial suture separates, the skull becomes thin and even transparent, percussion can Maceen’s sign may appear on percussion. The temporal frontal area shows angry veins, the eyes are downwardly rotated, and the upper sclera is often exposed (sunset sign). The infant is depressed and cannot lift the head. In severe cases, brain dysfunction may be associated with epilepsy, visual and olfactory disturbances, nystagmus, strabismus, limb paralysis, and mental retardation. Since the infant’s head is compensated for enlargement, headache, vomiting and optic nerve papillary edema are not obvious.
Diagnosis of hydrocephalus
(a) Medical history
1. Congenital hydrocephalus is symptomatic at birth, such as the more common Dandy-Walk anomaly (atresia of the fourth ventricular foramen, dilatation of the fourth ventricle, overgrowth of the skull, or cyst formation at the end of the cerebellum blocking the posterior cranial fossa), with a family history.
2. Secondary hydrocephalus may have a history of encephalitis and meningitis, or a postnatal history of intracranial hemorrhage.
3. Most of the patients have large head, backward intelligence, depression, lethargy, developmental delay and malnutrition.
(B) Physical examination
1. The head circumference increases, the fontanelle bulges, the cranial suture splits, the skull shape becomes round, there is a broken pot sound on percussion, the skull becomes thin and even translucent. Frontal and temporal veins can be seen in anger. Positive cranial transillumination test.
2. Both eyes are sunset-like, and most patients have nystagmus.
3. Patients often have twitching, or have repeated convulsive episodes. In addition, cranial nerve palsy, limb paralysis, high muscle tone or ataxia and other signs are seen.
(iii) Auxiliary examination
1. Cranial radiography or CT examination shows enlargement of the cranial cavity, thinning of the skull, separation of the cranial sutures and enlargement of the fontanelle.
2. Lateral chamber injection of neutral phenol red 1m1, lumbar puncture within 2 to 12 minutes, CSF visible phenol red, suggesting non-obstructive hydrocephalus. If 20 minutes CSF still does not see phenol red, suggesting obstructive hydrocephalus.
3. Ventriculography, using filtered oxygen slowly injected into the ventricles, and then do X-ray examination, can be observed ventricular enlargement and cerebral cortex thinning. If the thickness of the cerebral cortex is more than 2 cm and the hydrocephalus can be relieved, the patient is expected to recover intellectually. Ventriculography can also help determine the site of obstruction or detect intracranial tumors.
4. cranial ultrasound examination of the midline wave is not shifted, the lateral ventricle or the third ventricle are enlarged, etc.
5. fontanelle puncture can be used to rule out subdural hematoma or hydroma, both of which also often cause cranial enlargement. It is also possible to find out the thickness of the cerebral cortex and the intracerebral pressure (50-60 mm water column in normal infants).
The disease should be differentiated from subdural hematoma or effusion in infants, intracranial tumors, and rickets.
Treatment of hydrocephalus
Non-surgical treatment
Applicable to early stage or milder condition with slow development by.
(1) Application of diuretics or dehydrating agents, such as acetazolamide, dihydroketorol, tachyphylaxis, mannitol, etc.
(2) Repeated puncture and release of fluid through the anterior chimney or lumbar spine.
Surgical treatment
Surgical treatment is available for progressive hydrocephalus with significantly enlarged head and cortical thickness of more than 1 cm; surgical treatment is suitable for cases with high intracerebroventricular pressure (more than 250 mm water column) or failed by non-surgical treatment. Severe hydrocephalus, such as those with head circumference over 50 cm and cortical atrophy thickness below 1 cm, has been combined with severe dysfunction and deformity, surgical treatment is not effective. Surgery can be divided into the following categories.
1. Surgery to reduce cerebrospinal fluid secretion: cautery after choroid plexus resection, which is now used sparingly.
2. Surgery to relieve the cause of ventricular obstruction: such as cerebral aqueduct formation or dilation, median foraminotomy and removal of intracranial occupying lesions.
3. Cerebrospinal fluid shunt: The purpose of surgery is to establish cerebrospinal fluid circulation pathway and release the accumulation of cerebrospinal fluid, which is also used for traffic or non-traffic hydrocephalus. Commonly used shunts include lateral ventricle-cerebellar medullary pool shunt, third ventriculostomy, lateral ventricle-ventral, superior sagittal sinus, atrium, external jugular vein shunt, etc.
*Which patients are not suitable for surgical treatment?
For patients with severe hydrocephalus, low intelligence, blindness, paralysis, and obvious atrophy of brain parenchyma, the thickness of cerebral cortex is less than 1cm, all of them are not suitable for surgery.
Chinese medicine treatment
Acupuncture has not been recorded in ancient medical texts for the treatment of this disease. The first modern report was published in 1959, in which a child was cured by acupuncture in the Wei Zhong and He Gu areas [1]. Then, until the 1970s, the acupuncture community began to pay attention to the treatment of this disease again [2]. In the last decade or so, the number of clinical observation articles with larger samples has increased day by day, and not only the practice of acupuncture point stimulation methods, such as acupuncture with moxibustion, moxibustion with medicinal thread, and external application of Chinese medicine, but also the more in-depth exploration of clinical evidence and treatment rules. It has been tentatively concluded that, from the TCM classification, the kidney-yang deficiency is effective, while the spleen-kidney-yin deficiency, the acupuncture effect is poor; and from the Western medicine classification, it is found that acupuncture for the treatment of traffic hydrocephalus has high efficiency and stable long-term effect; obstructive hydrocephalus has low efficacy and poor prognosis.
*Body acupuncture
(I) Acupuncture points
Main points: Baihui through Si Shen Cong, Sanjiao Yu through Kidney Yu, and Sanyinjiao through Fuyao.
Matching points: selected by type.
Kidney Yang deficiency: the child has a large head, open cranial suture, full fontanelle, no vomiting or sunset signs, good body movement, normal food and stool. Only the main point is taken.
Spleen and kidney Yang deficiency: the child’s head is large, the cranial suture is split, the fontanelle is full, the tension is high, there is no vomiting, the sunset sign is not obvious, the abdomen is distended and the stool is loose, the spirit is fatigued, the movement of the limbs is still good.
Add Dazhi and Sansili.
Spleen and kidney yin deficiency: the child’s head is large, the cranial suture is split, the fontanel is wide and full, the tension is high, the face is white, the forehead veins are exposed, the mind is dull and irritable, the body is thin and neck is thin, vomiting and convulsions, the sunset sign is obvious.
Add Dazhi, Fengchi, Fengfu, Shui Shui through Zhongji, Shuosanli, Yinlingquan through Sanyinjiao.
(II) Treatment
The main acupuncture points are taken each time, and the rest are selected according to the TCM typology, except for kidney Yang deficiency. The acupuncture is done in a short time with moderate stimulation, with light twisting and slow lifting, 3 twists per point, 1 tight insertion and slow lifting, and so on for 3 times before discharging the needle. After each needle plus chiropractic 3 times, that is, from the coccyx to the back and shoulders for once, the gesture should be light and slow, or along the Governor’s and bladder meridians with skin needles lightly knocked 3 times. Once a day, 30 days as a course of treatment, stop acupuncture 3 to 5 days to renew treatment. If there is no obvious effect in three courses, it is appropriate to use other methods instead.
(C) efficacy evaluation
Efficacy criteria: cured: head circumference returned to within the standard limit for children of the same age, fontanelle flat or depressed, cranial suture completely closed, limb activities and food and stool are normal; effective: head circumference normal or slightly more than the standard limit for children of the same age, fontanelle slightly raised or flat, but tension is not high, other symptoms have different degrees of improvement; ineffective: after one to three courses of treatment, signs and symptoms are not significantly improved.
A total of 76 cases were treated and evaluated according to the above criteria: 44 cases (57.9%) were cured, 13 cases (17.1%) were effective and 19 cases (25.0%) were ineffective, with an overall efficiency of 75.0%. The kidney-yang deficiency type was highly effective, while the spleen-kidney-yin deficiency type was the worst [3].
*Comprehensive method
(I) Acupuncture points
Main acupoints: in 2 groups. 1, Shuigou, Zhigou, Sishencong, Hegu, Shui Shui, Yinjiao, Zhongji, Dao Shui, Yinlingquan, Feet Sanli, Sanyinjiao, and Fuyao; 2, Fengfu, Fengchi, Dazhi, Lifemen, Lumbar Yu, Yinmen, Zhizhong, Chengshan, and Jiejiao.
(II) Treatment
Take 1 group at a time, and add or subtract as appropriate according to the condition of the child. In the early stage, the acupuncture points are mainly punctured or stimulated for a short period of time, and after adaptation, the acupuncture points of the limbs can be left for 20-30 minutes. Before each prick, tap the pinch point with a skin needle from top to bottom until the skin is flushed. For those who have little urine, fontanelle does not shrink, and cold extremities, moxibustion with a moxa stick is used to gyrate the moisture, yinjiao, and guangyuan points for 5 to 10 minutes each time. To enhance the effect, topical herbal medicine can be applied to the head of the child. Acupuncture once a day, 30-50 times for a course of treatment, the course of treatment interval of 10 days. Chinese medicine is applied every other day.
Topical Chinese medicine preparation: 10 grams of Euphorbia, 10 grams of Coriander, 10 grams of Gansui, 10 grams of Shangluo, 1 gram of ice chips, 10 mg of musk, finely powdered and mixed into a paste with vinegar or petroleum jelly.
(C) efficacy evaluation
A total of 69 cases were treated, 51 cases (73.9%) were effective and 18 cases (26.1%) were ineffective. For further analysis of 35 cases, it was found that for 13 cases of traffic hydrocephalus, 11 cases (84.6%) were effective and 2 cases (15.4%) were ineffective, while for 22 cases of obstructive hydrocephalus, 9 cases (40.9%) were effective and 13 cases (59.1%) were ineffective. During the follow-up period from 6 months to 6 years, 7 cases of traffic hydrocephalus were basically cured, 5 cases continued to improve, and 1 case deteriorated; 1 case of obstructive hydrocephalus was basically cured, 9 cases continued to improve, 8 cases deteriorated, and 4 cases died. It showed that the former was superior to the latter in both immediate and long-term efficacy [4-7].
*Acupuncture
(I) Acupuncture points
Main acupoints: Baihui, Guanyuan, and Yongquan.
Supporting points: Kidney Yu and Spleen Yu for obstructive hydrocephalus; Gao Jian and Zhen Men for obstructive hydrocephalus.
(B) Treatment method
The method of acupuncture followed by moxibustion is adopted. The main points must be taken, and the supporting points are selected according to the different types of symptoms. Guan Yuan is used as a tonic, and Yong Quan is used as a diarrhea, and the needles are discharged after obtaining Qi; Bai Hui is used as a flat tonic and flat diarrhea, and the needles are retained for 1 hour. The matching points are also taken after obtaining Qi. Then select the point and apply moxibustion. Among them, Baihui and Yongquan must be moxibustion. Use Zhou’s moxibustion frame to fix moxa, each point must be moxibustion after 1 moxa, to point area local flushing, not foaming as degree. Once a day, 3 months as a course of treatment, stop treatment for 1 month before the next course of treatment.
(iii) Evaluation of efficacy
The above method treated 27 cases of children, after 1-6 courses of treatment, 6 cases were cured, 6 cases were significantly effective, 4 cases were effective, and 11 cases were ineffective, with an overall effective rate of 56?5% [8].
Hydrocephalus care
1. Room temperature should be kept at 18-21℃, humidity at 55%, ventilation at regular intervals, and air circulation in the ward to provide a quiet, clean, comfortable and safe environment for treatment and rehabilitation.
2. Diet should be easy to open the brain, open the meridians, strengthen the spleen and kidney, fill the brain, strengthen the body and easy to digest food.
3, good psychological care, nursing staff should be kind, warm, patient care of the patient detailed understanding of the patient’s condition, family, social environment, to help the patient and family members to establish confidence to overcome the disease, actively cooperate with treatment, passive to active, to create an optimal psychological state to accept treatment and rehabilitation.
4. Measure the child’s head regularly and ask if there is any history of nausea and vomiting.
5. Observe closely the changes of vital signs when the intracranial pressure is increased, especially the changes of consciousness and pupils, the occurrence of brain herniation and the triad of intracranial hypertension (headache, vomiting, optic papilledema), make special care records and record the volume.
6. When applying mannitol to lower blood pressure, make sure to drip it quickly and finish it within half an hour, do not leak it into the skin to prevent local skin tissue necrosis.
7. Prevent complications, avoid moving when intracranial pressure is increased, put a soft pillow under the head to the side and elevate 15-30°, aspirate respiratory secretions in time to keep the respiratory tract unobstructed, pay attention to protecting the cornea and preventing decubitus ulcers when unconscious.
8. Prepare for resuscitation of critically ill patients (instruments, drugs), tracheotomy if necessary.
9, symptomatic care, notify the doctor when convulsions, sedation, oxygen when there are signs of hypoxia, heat treatment when hyperthermia.
10.Guide parents or assist patients to do functional training, mainly active movement.
11. Treat for disease etiology and rehabilitation treatment principles, and do discharge guidance to ensure treatment.
Hydrocephalus prevention
The key to control the occurrence of hydrocephalus is to eliminate the risk factors before fetal formation and the constitutive factors in the fetal and perinatal periods. This has its significance in preventing the occurrence of hydrocephalus. I. Etiological research to eliminate and improve genetic and environmental factors. The etiology of hydrocephalus malformation is complex and not well understood so far, but according to its epidemiological distribution and genetic characteristics, it is suggested that the disease is a multi-factorial disease caused by the combination of genetic and environmental factors, and some cases may belong to X-partnered inheritance as suggested by family investigation. Bickers et al. first reported X-associated recessive inheritance in three siblings who all suffered from hydrocephalus malformation, and their four uncles all died prematurely due to the disease. Habib, a foreign scholar, reported that a man who married twice had a normal boy after the first marriage, and his wife had a normal female child after the second marriage, in addition to two male children. Stevenson et al. concluded that a female child with polygenic inheritance is at low risk for reoccurrence of subsequent siblings, and if the child is male, it is X-companion recessive. If the mother is a heterozygous carrier, half of her sons will have the disease and half of her daughters will be carriers. Since male children do not live to reproductive age, the disease may be inherited through female carriers. Burto, a foreign scholar, suggested that 25% of male children with conduit stenosis may be due to X-partnered recessive inheritance. Statistics from Anhui province showed that three women with a history of delivery of hydrocephalus malformation in the monitoring group were hospitalized at the time of monitoring and delivered male children again, and one case was a same-sex male twin-born child with the same disease, suggesting that it may be inherited through X-partnered recessive inheritance. In addition to genetic factors, intrauterine infection with viruses (rubella virus, cytomegalovirus, herpes simplex virus, etc.) and Toxoplasma gondii has become increasingly important since the 1960’s. Although the symptoms caused by the infection to the pregnant women themselves are mild, it has a greater impact on the development of the embryo, which can lead to fetal abortion, stillbirth, stillbirth and a variety of serious congenital malformations, among which Toxoplasma gondii infection can cause hydrocephalus malformation in fetuses with narrowed aqueducts. Lu Shen et al. reported that intrauterine Toxoplasma gondii infection caused hydrocephalus in 4 fetuses, and the trophozoites and pseudocapsules of Toxoplasma gondii were found in the cerebrospinal fluid smear of the children. In addition, radiation factors such as early pregnancy radiation, radioactive elements, microcomputer and cell phone are related to the formation of hydrocephalus. It can be tentatively assumed that hydrocephalus malformation is a multifactorial genetic disorder caused by a combination of genetic and environmental factors. In order to reduce inferior births and improve the health quality of the population, in addition to etiological research; premarital examination should be conducted; inbreeding is strictly prohibited; and genetic counseling should be carried out.
Second, strengthen prenatal early diagnosis and early termination of pregnancy to prevent the birth of children with hydrocephalus. Early prenatal diagnosis of children with hydrocephalus is an important way to prevent the birth of children with hydrocephalus. As obvious hydrocephalus can be detected by ultrasound at 12 – 18 weeks of pregnancy, it is necessary to strengthen the application of ultrasound in prenatal diagnosis, early termination of pregnancy to prevent the birth of hydrocephalus and reduce the birth rate of congenital hydrocephalus.
Third, to promote eugenic knowledge and reduce the number of fetuses. According to relevant data, the risk of hydrocephalus in the fetus can be increased by the increase in the number of births of pregnant women. The incidence of hydrocephalus increases significantly in those with more than two children. Therefore, to promote knowledge of eugenics, reduce the number of births, is one of the ways to prevent hydrocephalus children.
Fourth, advocate appropriate age birth from the relevant data show that the incidence of hydrocephalus malformations with the increasing age of pregnant women and the trend of increasing. Generally, the incidence is lowest in the group of 25-29 years old, but the difference is not significant, and after 30 years old, the incidence has an increasing trend. Therefore, advocating the appropriate age of childbirth is of some significance to prevent the occurrence of hydrocephalus children.
Fifth, strengthen eugenics education and improve the cultural quality of the population. According to relevant statistics, the occurrence of hydrocephalus children and maternal literacy, the lower the literacy of pregnant women, the higher the incidence of illiterate and semi-literate offspring have the highest rate of disease. Therefore, in order to improve the health quality of the population, the first step should be to improve the cultural quality of the population, in order to enhance the public’s ability to accept eugenics education and self-care awareness.
Sixth, safe delivery, beware of suffocation, birth injuries. When a pregnant woman gives birth, she must give birth in a hospital with good environmental conditions, do not delay the delivery process, beware of perinatal asphyxia and prevent birth injuries. This is an important part of preventing the occurrence of perinatal hydrocephalus children.
Diet for acute hydrocephalus
Patients with acute hydrocephalus are in critical condition and often suffer from vomiting, excessive sweating, fever, respiratory distress, hypoxia, dehydration and diuretics, which can easily lead to dehydration, acidosis and electrolyte disorders, so it is extremely important to ensure nutritional supply, maintain water-electrolyte balance and provide good dietary care during the acute period.
In acute hydrocephalus patients who cannot eat when their condition is stable, nutrition and water are supplemented by intravenous infusion. The daily intake should not be too much, generally around 2000ml. In milder cases, those who are more conscious and have no swallowing disorder can be helped to eat liquid or semi-liquid. The food should be light, small and frequent, and the temperature should not be too cold or too hot.
Feeding acute hydrocephalus patients should pay attention to: 1, if the patient chewing and swallowing of the random movement is affected, the tongue muscle movement paralysis resulting in stirring failure, therefore, can not send food between the upper and lower teeth, and can not push the food to the pharynx, but the patient swallowing reflex is still there, can send food to the root of its tongue, causing the swallowing reflex to swallow food. 2, hydrocephalus with hyperlipidemia has atherosclerosis in the diet to limit Animal fat, it is best to consume vegetable oil. When patients with facial and tongue palsy eat, food can easily fall out from the corner of the mouth on the paralyzed side or be retained in the cheek on the paralyzed side, so when feeding, the patient should lie down on the healthy side. After feeding, the patient should be fed water to rinse the oral residue or scrub the oral cavity with cotton balls. Special attention should be paid to washing the cheek of the paralyzed side to prevent oral inflammation, reduce bad breath, enhance appetite and promote digestive function.
Diet for hydrocephalus
Modern research shows that substances closely related to the brain are mainly fat (unsaturated fatty acids), protein, sugar, vitamin C, vitamin B, vitamin E, calcium, trace elements such as zinc, copper and selenium.
Brain weight of 50% to 60% is fat (unsaturated fatty acids), unsaturated fatty acids are the main raw material for brain cell composition, which is mainly linoleic acid, linoleic acid and arachidonic acid and other three fatty acids, especially the first two are important components of the composition of brain cells. They play a very important role in promoting the development of brain cells and ensuring their good function, but these fatty acids cannot be synthesized in the body and must be supplied by food (essential fatty acids). Therefore, providing the brain with good quality and rich fats can promote the development of brain cells and the formation of nerve fiber sheaths, and ensure their good function.
Containing more of such substances are: animal meat such as hare, pig, sheep, duck, chicken, quail, sparrow; oyster, octopus, sea fish; walnut, sesame, pine nuts, peanut kernels, pumpkin seeds, sunflower seeds, watermelon seeds, almonds, dried fruits, vegetable oils, etc.
Vitamin C can promote the solidity of cell structure, and can eliminate the relaxation or tension of intercellular structure, so that the metabolic function of the body is vigorous, which is the necessary substance for brain development. If vitamin C is insufficient, it tends to reduce the activity of brain cells and make them dysfunctional. In case of severe deficiency, it causes weakened response of the brain and body to stimuli and is prone to scurvy, diseases of teeth, gums, skin, hair, bones and joints, and even leads to arteriosclerosis and cancer. Adequate vitamin C can make the brain function flexible and sharp, and can improve the IQ of children.
Containing more of these substances are sour dates, fresh dates, strawberries, grapes, persimmons, kumquats, apples, pears, hawthorn, pineapples, radish leaves, tomatoes, cabbage, green tea, potatoes, etc.
Protein is one of the main components of brain cells, accounting for 30% to 35% of the weight of the brain stem, is the main material basis for the excitation and inhibition process of brain cells, in memory, language, thinking, movement, nerve conduction and other aspects have an important role, brain development and nutrition, and the adequate supply of protein has a close relationship. Research data on humans and animals show that in the case of insufficient protein supply, brain cells are poorly developed, their number, size and branching richness will be affected; and the lack of protein on the brain can be serious effects for generations.
Rich in protein are: eggs, wild boar meat, wild rabbit meat, wild duck, pheasant, quail, sparrow, etc.; non-farmed fish and shellfish such as oysters, octopus, squid, shrimp, etc.; beef, pork, chicken, etc. and soybeans and soybean products, peanut kernels, pinto beans, broad beans, sesame, walnut kernels and other dried fruits.
The trace element zinc has a certain role in maintaining the function of the brain, and the lack of zinc in the body can affect the intelligence of children. Zinc plays an important role in the normal development of children and adolescents, and it is also a coenzyme of superoxide dismutase and other antioxidant enzymes, which has a role in anti-aging. Studies have confirmed that an imbalance in the ratio of zinc to copper in the body can lead to a significant increase in the incidence of diseases such as atherosclerosis and stroke.
Foods rich in zinc include: oysters, malt, mushrooms, refined flour, eggs, rabbit, chicken, peanuts, peas, beans, cucumbers, garlic, etc.
Second, the proverb – hydrocephalus
”Why are you so stupid, is it hydrocephalus?” , “Look what you’ve done, hydrocephalus!” Folk often use “hydrocephalus” to ridicule someone clumsy, slow, easily fooled, naïve and ridiculous.
Types of obstructive hydrocephalus
Obstructive hydrocephalus is often accompanied by hydrocephalus. The essence of this type of hydrocephalus is that a large amount of cerebrospinal fluid from the ventricles infiltrates the atrophied brain tissue, causing it to contain excess tissue fluid.
Obstructive hydrocephalus can pass acutely or can develop into a progressive type. It can also be divided into progressive and stable phases according to its pathological course.
In obstructive hydrocephalus, if we go by the site of cerebrospinal fluid pathway obstruction, we can classify obstructive hydrocephalus into the following types.
(1) hydrocephalus on one or both ventricles caused by interventricular foramen or third ventricle obstruction
(2) Hydrocephalus in both lateral ventricles and the third and third ventricles caused by obstruction of the middle cerebral aqueduct
(3) Hydrocephalus in both ventricles and the third ventricle caused by obstruction of the fourth ventricle, and dilatation of the middle cerebral aqueduct
(4) Obstruction of the median foramen and lateral foramen of the fourth ventricle causes hydrocephalus in the lateral ventricles, the third ventricle, the middle cerebral aqueduct, and the fourth ventricle; obstruction of the middle cerebral aqueduct, median foramen, and lateral foramen causes dilatation of the lateral ventricles and the third ventricle, resulting in symmetric hydrocephalus; obstruction of the interventricular foramen or one of the lateral ventricles causes total or partial dilatation of one of the lateral ventricles, resulting in asymmetric hydrocephalus.
(The following four figures are in order: hydrocephalus in infants, CT manifestation of hydrocephalus, V-A shunt, V-P shunt)