Case # 3: Subarachnoid Hemorrhage after Head Injury

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December 21^st, 2004 Bill called at the urging of his wife Martha. Bill was 65 years old and a very active sailor. I had seen him on occasion for chronic treatment for several years. He just returned from the ER and needed an acute consultation. He had fallen off a ladder while refurbishing his boat and hit his head against the toolbox. After getting up he had noticed his back hurt, which was not a surprise since he had a chronic back problem. But what was disconcerting to him was a gurgling in the back of the throat and blood running from his nose and mouth. Looking in the mirror he fully expected a major gash on the side of his head where he had collided with the toolbox, but there was only a minor bruise. Concussion
He had asked his wife to take him to the ER. The physical exam and X-ray found a fractured rib, a punctured lung, a thoracic spine fracture, a possible facial bone fracture and a contusion at the left side of his head. By now he also had a major headache.
I selected Arnica montana, to match the injuries of the fall, including possible brain trauma. This was to be given in alternation with Bryonia alba, which covered pain worse from slightest motion, and Symphytum officinalis, which covered fractures of the rib and vertebra. All of these were to be taken in Q-potencies, a plussed liquid dose every half hour, next higher potency after ten doses. We decreased the number of doses to standard protocol,[3] or once per day, once he was stabilized. He was also told it might be beneficial to take vitamin C along with Echinacea angustifolia (HPUS) tincture for the first week, five drops twice daily, a measure that often helps prevent possible infection and improves healing from serious injury. As always, I strongly urged him to continue to have regular medical exams—something I did not have to convince him of this time!

January 26^th, 2005

By now the full impact of the injury was evident. Bill had taken the remedies, and had also seen his doctor who gave him Percocet and Endocet for pain. There was a pain in his nose, extending into his left eye. His vision was okay. He complained of difficulty thinking and had noticeable trouble expressing himself. He had trouble articulating words, slurring his speech slightly. His head felt “strange” at times. He said it felt as if he had hit his head. However he did not have a headache any more, just a “strange” feeling. At first he had felt quite depressed, but this improved once he started taking pain medication. He was also taking Fioricet. In addition, he still had pain in his torso while sitting upright and while standing. This pain was better when lying down. He also felt a tingling in his left hand. There was a change in his voice and after being questioned he admitted he had noticed it, too. He seemed unusually slow to respond to questions. He complained of feeling drained, and a lack of energy. He seemed dull and confused and there were long pauses in his report.
While it is difficult to assess such symptoms over the phone, I had no doubt that he had suffered significant brain trauma. The doctor had scheduled a CT scan for the next week. I was familiar with this group of symptoms and what it could mean. I would not have been surprised if the scan found a hemorrhage or extravasation into the subdural or subarachnoid space, or worse.
It is interesting to note that Gelsemium sempervirens is the only remedy listed in the Complete Repertory under the rubric “subarachnoid hemorrhage”. Even though it had not been confirmed, there was no risk in giving a remedy to cover this eventuality. A careful repertorization of his symptoms yielded the remedy Lachesis. I selected both, to be alternated with Arnica montana and Symphytum officinalis. I also chose Hypericum perfoliatum, to address a possible spinal concussion. Hypericum perfoliatum has also proved very useful in cases of brain trauma. The instructions were the same: plussed liquid doses of Q-potencies every half-hour in alternation, increasing potency after 10 doses of each level. Since he had discontinued Endocet and Percocet, I also chose Endocet and Percocet in 30c potencies, three doses per day, for three days, which is my standard protocol for antidoting the effects of drugs.[4] This can be very important, as sometimes remedies do not act unless the system is freed from the lingering suppressive effects of these drugs. He was to let me know as soon as possible the results of the CT scan.

February 4^th, 2005

Bill called in the early morning and seemed more alert. He ordered higher levels of his remedies, stating he felt much better. He felt he had almost completely recovered from his rib and back fracture. Although he still had a lot of pain, he continued to feel much better in general. He reported he still felt “weird in his head,” so he was going to have a brain scan later that day and would let me know the results right away. The same remedies were selected, including also several doses of X-ray 30c in liquid doses to be taken after the CT scan to clear the harmful effects of multiple X-rays.
Later the same day, Bill’s wife Martha called. She said the scan had found a subarachnoid hemorrhage and that surgery had been recommended. She had asked the surgeon if there were any risks and he had been wishy-washy, not denying risk but seemingly downplaying it. After she insisted, the surgeon suddenly said, “Yes, the risk is quite serious; this is a very serious condition, you could die from it. But it needs to be done. There is no other way.”
Martha herself had chronic lymphocytic leukemia and had been under homeopathic treatment for twelve years, avoiding chemotherapy, and with good results. Her confidence in homeopathy and in her practitioner was almost unlimited. She even said she would not support Bill if he chose to have the surgery.

February 6^th, 2005

Bill called again for a consult. He did not bring up the idea of surgery, so I did not mention it either. But he did mention a laundry list of symptoms, some of which he had not reported previously.
He had begun to feel a mild to moderate sensation of pressure in his head, but no pain. He had trouble sleeping from discomfort in his rib and also from intermittent pain in the middle of his back. The pain appeared to be in the cartilage where the rib was attached to the spine and worse on the left side. This pain was mild to moderate while sitting upright in a chair, with a sensation of pressure on his spine, about ten inches below the shoulder blades. There was still tingling in his left hand. Turning to the left was painful. There was also pain from the right shoulder down into his right arm.
Bill had begun to wake at 2.30 a.m. feeling he needed to turn, but since it was painful to turn he sat up instead. While sitting, throbbing in his occiput would develop along with pain in the neck. The pain was better lying on a pillow. Apparently, this had been there since the accident but was getting progressively better.
He also had mild vertigo on exertion such as going up several flights of stairs. He once had trouble “seeing” things accompanied by blurred vision, lasting about 5-6 hours. It was, “as if I was unable to focus and then it went away.” He had no problem speaking and I noted that this was much improved; no more slurring of speech and normal articulation. Since the accident, he had bleeding gums with bright red blood.
Bill had seen a neurosurgeon at DUMC for a second opinion and this doctor wanted to do more scans. He was taking all remedies once daily now. Based on the progress and the symptoms, I saw no need to change remedies except to keep increasing the potencies after 10 doses of each Q-potency to the next higher level.

February 16^th, 2005

Martha called to say that the DUMC surgeon confirmed the subarachnoid hemorrhage: the image showed a hematoma. He also recommended surgery. “He said there was no better way. Bill told him they [he and Martha] would keep him posted on their decision.” The next higher levels of remedies were ordered. He took another “round” of X-ray 30c clearing to antidote the CT scan.

March 3^rd, 2005

By now, Bill and Martha had decided against surgery, encouraged by his improvement from the homeopathic treatment. Bill had another scan and, “everything looked improved, which was encouraging.”  Bill felt a little better overall. The sensation of pressure in his head had not increased but was still there. Sometimes he had a very slight headache but it no longer concerned him. However, he reported that the previous week he had a discouraging episode while giving a lecture. Bill was a professor at a nearby university.  “I was unable to find the right word, unable to ‘ad lib,’” which was normally no problem for him. While in the past speaking in front of people had never been a problem, at least not since adolescence, now he felt it was. Upon further questioning, he offered that he had noticed a subtle change since his injury on speaking in front of a large group of people. He reported that on this last occasion, he struggled for a while before ending the lecture early.
His right arm was doing better, though still painful. He noticed weakness of the right arm in certain positions and also a lack of strength in the left arm. He talked slowly and on being questioned, he said he still had trouble thinking. “It’s as if I could not get the material or my thinking process organized right in my head.” During our conversation he was stumbling over words several times and seemed unusually tense but he loosened up after a while. He admitted he had fears after the speech episode, and the fear came back every so often.
Something was obviously still wrong. While there was steady progress in his overall recovery the injury was still affecting his speech and his emotional state. My assessment of the situation was a general weakening of this overall constitution by the repeated X-rays and scans. He had another scan scheduled in a few weeks. The doctor again had urged that surgery be scheduled.
The remedy X-ray 1Q was added to the mix, along with a constitutional remedy, Lycopodium clavatum, to cover the symptoms of weakness and fear, especially fear in front of a crowd, the speech related fears, and the stumbling over words because of a neurological inability to “think on his feet.” Lycopodium clavatum had served Bill well in the past and was to be taken in alternation with existing remedies that were still indicated in the same doses, once per day each, to ten doses each level.

March 26^th, 2005

Bill had another CT scan. The image showed the hematoma had disappeared. The doctor said he did not need to do another scan. The doc also said that the result was “unusual.” Bill asked the surgeon about his previous insistence that he needed surgery. The surgeon shrugged his shoulders and said, “I have never seen anything like this. What did you do? Go to a witch doctor?” Bill only laughed. He never told the doctor that he used homeopathy.
My assessment was that Arnica, Symphytum, Gelsemium, Lachesis, X-ray and Hypericum were no longer needed and should be discontinued. Only Lycopodium was still indicated.
Over the next two months it was noted that there were no relapses and no more abnormalities in Bill’s mental state, cognitive or language abilities. However, on July 1^st, 2005 he complained of pain in the right hip, sciatica and occasional severe pain in his ankles and feet, better from walking, for which he was taking Naproxen. The vertebral fracture had complicated his chronic lumbar problem, and an MRI showed bulging of three lumbar discs. Rhus toxicodendron in Q potencies, three times daily, in alternation with Lycopodium, got him over the pain and allowed him to discontinue his medication.