This exhibit compares the normal circulation of cerebrospinal fluid (CSF) within the brain to a brain with an epidural hematoma and CSF leak. CSF is produced around blood vessels, along the ventricular walls, and by modified ependymal cells in the choroid plexus. Normally, CSF circulates into the lateral ventricles, third ventricle, fourth ventricle, median aperture, lateral apertures, and subarachnoid space surrounding the spinal cord and brain. The injured brain has an excess of intraventricular air and an epidural hematoma. The surrounding vasculature is compressed, causing ischemia. The herniated brainstem effaces the fourth ventricle, preventing CSF flow from the skull to the spinal cord.
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