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If the images are real, the most likely explanation is a ventriculoperitoneal shunt placement. It could explain why he doesn't want his records released. It is possible that he may have had hydrocephalus as an infant. If so, at that time, the treatment would have been to drill a burr hole in the skull, place a catheter into one of the ventricles of the brain and run a tube subcutaneously down the side of his neck usually into the abdominal cavity. The blockage of cerebrospinal fluid then has an alternative source of flow and is absorbed inside the belly as opposed to flowing out around the outside of the brain and down the spinal cord.

To try to hide this would make sense because often children with these problems end up with some neurologic damage, although many also turn out just fine.

However, even the question about this possibility could have been a political disaster for anyone seeking to be POTUS.

It could explain the secrecy around the birth and medical records.

Again, this is speculation based on the assumption that the shadows on the photo really represent something. If they are real, then I think this is the most likely explanation.

Just to clarify my speculation, if he had hydrocephalus as an infant, often no burr hole needs to be drilled because the fontanelles are not yet closed. Usually, burr holes only need to be drilled after that happens which would make it a later occurrence. Again, just my speculation.