Hemispherectomy

June 29, 2006 9:15 AM

Living with half a brain - hemispherectomy, probably the most radical procedure in neurosurgery
posted by Gyan (50 comments total)

It's quite grisly.
posted by Drexen at 9:27 AM on June 29, 2006

Children do seem more resilient than adults, and I do hope and suspect that the operation on this little baby girl will be a huge success. God bless her.
posted by rinkjustice at 9:27 AM on June 29, 2006

[insert George W Bush joke here]
posted by Flashman at 9:35 AM on June 29, 2006

Freaky identity stuff too. Are you still you with half your brain? If not, then who are you? If you are you, then who is the other half of the brain if you transplanted it to another body? They would be different people. argh [head xplode]
posted by -harlequin- at 9:37 AM on June 29, 2006

Thanks for taking care of that, Flashman.
posted by MrMoonPie at 9:39 AM on June 29, 2006

Shades of A Scanner Darkly...
posted by brundlefly at 9:49 AM on June 29, 2006

I have half a mind to....
posted by Floydd at 9:50 AM on June 29, 2006

That was a really interesting article. Also the whole concept of our brains being able to adapt more than was thought before. And how we use different parts of our brains at different times of life. All fascinating stuff.
posted by gomichild at 9:51 AM on June 29, 2006

this article was amazing. thanks for posting that.
posted by Sijeka at 9:53 AM on June 29, 2006

Amazing stuff, thanks Gyan.

What truly amazes me about the brain is how little we actually know about how it works.
posted by grapefruitmoon at 9:56 AM on June 29, 2006 [1 favorite]

Shades of A Scanner Darkly...

I'd say more shades of bicameralism. Both in the article, and in A Scanner Darkly it's the extra (superfluous(?!)) half brain that's causing the problem; the patients here seem amazingly functional.

(Not that Scanner isn't the only non-snake, non-plane related film I'm planning to see this year...)
posted by hoverboards don't work on water at 9:58 AM on June 29, 2006

Half a [brain], philosophically,
must eo ipso facto half not be
But half a brain has got to be,
vis a vis its entity
- D'you see?

But can a brain be said to be
Or not to be an entire brain,
When half the brain is not a brain
Due to some ancient injury
- Singing! ...

La, di di, one two three
Eric has Half a Brain
A B C D E F G
Eric has Half a Brain
posted by blue_beetle at 9:59 AM on June 29, 2006

“You develop a feel for the brain,” he said. “Normal brain feels like a very soft boiled egg. A bad brain feels like a mushy apple.”

This is fascinating.
posted by noble_rot at 10:06 AM on June 29, 2006

What truly amazes me about the brain is how little we actually know about how it works.

That was true about ten to twenty years ago. Try taking a neurobiology course.
posted by j-urb at 10:21 AM on June 29, 2006

My brain does not like to hear details of other brains and how they go bad, and punishes me by trying to fling the most recently eaten food back out my mouth.
posted by Astro Zombie at 10:21 AM on June 29, 2006 [1 favorite]

Insert GW gif.
posted by mert at 10:38 AM on June 29, 2006

j-urb: The difference is now we know a hell of a lot more about how little we know about how it works.

— 3rd year cognitive neuroscience graduate student
posted by dmd at 10:46 AM on June 29, 2006

I love the idea that the brain has redundancy built into it as a design, I wish more software applications had the same feature...
posted by lilboo at 10:46 AM on June 29, 2006

Fascinating stuff. This is a good example of why I like Metafilter.

I should ask my cousin if he's ever done or assisted in one of these procedures (unlikely as that may be).
posted by clevershark at 10:47 AM on June 29, 2006

I should ask my cousin if he's ever been subjected to one.
posted by adamgreenfield at 10:49 AM on June 29, 2006

Reading about split brain patients in Drawing on the Right Side of the Brain made me love that we are "meat that thinks" and I can't get enough of stories that show how hardware problems can cause software problems.

Also, reading the story, I can't imagine the pain the parents had to go through. Imagine giving the authorization to remove half of your child's brain? Imagine the fear if it doesn't work right? or if they turned out with a different personality? I just can't imagine how scary that must be.
posted by Brainy at 11:08 AM on June 29, 2006

That was true about ten to twenty years ago. Try taking a neurobiology course.

Jesus, scientists are smug. It doesn't matter how many times their claims to know everything are disproved, they keep thinking this time they're right, dammit. Then history jerks the football away one more time.

At the end of the 19th Century, great names like Lord Kelvin or Auguste Comte in France, proclaimed that everything had been discovered in physics and that "there is nothing left for future generations but to add a few figures after the comma". Try taking a physics course, silly person, and stop pestering me with your questions about the speed of light!
posted by languagehat at 11:08 AM on June 29, 2006

Oh, and great post!
posted by languagehat at 11:09 AM on June 29, 2006

Thanks for taking care of that, Flashman.

Yeah, sorry, my ego got the better of me and I feel like a bit of an asshole for writing that, taking the mirthful wind out of the sails of whoever might actually have had a decent GWB gag etc...
Not the first time I've wished MF had a delete/retract function.
posted by Flashman at 11:23 AM on June 29, 2006

Really interesting. I was under the same impression as some mentioned in the article that the speech center was in the left hemisphere. The story of the 13 year-old who had the left side of the brain removed and could still communicate seems to put the lie to that.

I would have thought this possible maybe only in very young patients whose brains might afterwards develop in such a way as to compensate for the loss, but not in someone as old as 13. That is quite amazing. Thanks for the post.
posted by Tullius at 11:28 AM on June 29, 2006

Tullius : "I was under the same impression as some mentioned in the article that the speech center was in the left hemisphere. The story of the 13 year-old who had the left side of the brain removed and could still communicate seems to put the lie to that. "

More likely, there's no rigid (genetically or otherwise) imprinted map of brain activity. Brain regions assume function as per some architecture. If the substrate of the mind (brain matter) is modified/removed, the architecture reasserts itself as best it can upon the new layout.
posted by Gyan at 11:36 AM on June 29, 2006

This is really interesting, but at the same time...eeeyuck...

"as the lobe was severed, they came apart like string cheese."
posted by tastybrains at 11:38 AM on June 29, 2006

j-urb writes "That was true about ten to twenty years ago. Try taking a neurobiology course."

I don't have time to take a neurobiology course right now, but I'm curious about this. Could you briefly explain the mechanism of redundancy that allows these patients to function relatively normally?
posted by mr_roboto at 11:45 AM on June 29, 2006

Fascinating.

My heart broke for those parents. What a difficult choice to make. Yet how heartbreaking to live with the seizures that this procedure is attempting to treat.
posted by raedyn at 12:22 PM on June 29, 2006

Fascinating. The plasticity of the brain and its adaptation to events is something to remember when studies crop up showing, for example, sex or sexual orientation differences in brain structure. Which came first, the bit of the brain that lets you read maps or the reading of maps? I'm no neurobiologist, but this is certainly a field where the standard of evidence is high for any claim concerning brain structure and function.
posted by alasdair at 12:27 PM on June 29, 2006

Wow. Thanks for the article. Amazing.
posted by rsanheim at 12:37 PM on June 29, 2006

mr_roboto writes "Could you briefly explain the mechanism of redundancy that allows these patients to function relatively normally?"

According to TFA, no one can quite explain that.
posted by clevershark at 12:37 PM on June 29, 2006

What amazes me is that, if someone all of a sudden strokes out half of the brain, more likely than not they are not going to survive. Yet a lot of these people develop their seizures when they’re very young, or in utero, and when you take out half of their brain in one sitting it’s as if they weren’t touched.”

Perhaps what occurs in these cases is that during development, these patients' brains map all the functions that are supposed to be in the deficient hemisphere into the working one. That way, when the damaged hemisphere is removed, little function is lost because the patient wasn't using it for anything anyway.

I wonder if patients who had this procedure done due to a condition that developed in adulthood lose more function?
posted by Mitrovarr at 12:49 PM on June 29, 2006

At 2-year-old age, the human brain is still at the early stage of development. It is remarkably resilient and can adapt to a lot of drastic changes. Even in an adult brain, some rewiring of neural connections can be formed after parts of it get removed.

Have to admit that living with half a brain is rather extreme. Hopefully the other side will take over most of the functions.
posted by TurkeyWalk at 1:03 PM on June 29, 2006

I wonder about the people that have had this done at a later age. What would your memories of your preoperative self be like?
posted by Slarty Bartfast at 1:32 PM on June 29, 2006

Thanks to alcohol, I've been working with just my lizard brain for years.
posted by Astro Zombie at 1:38 PM on June 29, 2006

As long as we're in IGetMyScienceFromTheNewYorkerFilter, there was a a lovely article on stereo vision in the June 19th edition, which i don't think was linked here.
posted by arialblack at 1:42 PM on June 29, 2006

Well, J-Dub, if you took a neurobiology course, or have a degree in it as I do, you'd know that although we've made great strides in understanding the brain, there is a HUGE amount we do not know, and not just in little specifics, like which proteins are used to signal what cell conditions and stuff. We're still wondering about the nature of memory and how it's stored, the "feel" of consciousness, the micro-workings of the visual system, and a hundred other major areas.
So please don't be so smug about your Neuro 101 course when there is a whole world of science out there, in that subject, that you do not know.

As to this condition, it really is interesting - I saw a kid in person in a later course who had had a hemispherotomy - a total disconnection of half the brain but not removal - due to extreme epilepsy. he was maybe 8 and he'd had the surgery at I think 4, and he was totally functional, a little wonky because his brainw as still getting used to it, but he was off playing a gameboy until the prof called him up to perform the neurological exam and he looked totally normal.
posted by BlackLeotardFront at 1:45 PM on June 29, 2006

Well, I have taken a neurobiology class and the simple fact is that there is a lot, lot, lot we don't know about how the brain works, especially on the level of human experience. I mean we know what the brain does when we do something like throw a ball, or see or hear something, but we simply do not understand structurally things like feelings, thoughts, and emotions. Each side of the brain is very similar but there are clearly differences, some of which are genetic on both sides.

Maybe there's some "redundancy" maybe there isn't. Either way, no person could describe structurally what those things are at this point in time.
posted by Paris Hilton at 1:48 PM on June 29, 2006

Also, what happens to the girls eyes? would she blind/deaf on one side?
posted by Paris Hilton at 1:52 PM on June 29, 2006

Yeah, sorry, my ego got the better of me and I feel like a bit of an asshole for writing that, taking the mirthful wind out of the sails of whoever might actually have had a decent GWB gag etc...

While I appreciate your gracious apology, may I suggest a slight rewording?

Yeah, sorry, my ego got the better of me and I feel like a bit of an asshole for writing that, since GWB gags don't really have a place in a thread about neuroscience.
posted by languagehat at 1:55 PM on June 29, 2006

Also, what happens to the girls eyes? would she blind/deaf on one side? - Paris Hilton

It's different for different people, according to the aricle. The 13 y.o. girl they interviewed had reduced vision on the side of each eye that corresponded to the hemisphere she'd had removed. Corrective lenses made some improvement. The article also referred to modifications made to that girl's car in order to accomodate her vision and physical impairments including extra mirrors and a different steering apparatus, etc. So obiviously there are some lasting effects from the surgery. It's remarkable how much function is retained even with the loss of a substantial portion of brain matter and the doctors in the article agreed.
posted by raedyn at 2:05 PM on June 29, 2006

Yeah, the brain is very flexible but obviously there are limits. See for example the savant Kim Peek, who has a damaged cerebellum (since birth) and low motor skills because of this. He also never had a corpus callosum btw.
posted by vertriebskonzept at 2:23 PM on June 29, 2006

re: Kim Peek -- interesting link, thanks! Especially this: his father said that he reads the left page of an open book with his left eye and the right page with his right eye. I guess it takes a disconnected brain to be able to concentrate on two pages simulatenously.

Speaking of absent corpora callosa, there are a few strains of mice that are notable for having a high percentage of pups born without a CC. I understand that those mice without a CC are behaviourally not much different from normal mice, unlike humans, where agenesis of the CC usually causes symptoms.
posted by greatgefilte at 3:20 PM on June 29, 2006

I read Zen and the Brain once. It made my head hurt quite a lot.

And after reading the surgical account, I think my testes have gone permanantly into hiding.
posted by Sparx at 4:01 PM on June 29, 2006

Flashman, dude, I didn't mean it as a criticism, really. I laughed when I read your contribution. I figured there'd be lots of lame-ass Bush jokes, and your comment did a good job of pre-empting them.
posted by MrMoonPie at 4:51 PM on June 29, 2006

radical, dude.
posted by geekyguy at 4:54 PM on June 29, 2006

PBS did a series "Secret Life of the Brain" that covers a few of the kids who've had this done, and how they've coped regaining function. It is quite good, in the opinion of this nonscientific person.
posted by overanxious ducksqueezer at 5:19 PM on June 29, 2006

“You develop a feel for the brain,” he said. “Normal brain feels like a very soft boiled egg. A bad brain feels like a mushy apple.”

"as the lobe was severed, they came apart like string cheese."

I think the doctor last name was Lecter, he's enjoying that comparisons a little too much.

Of course the idea of half-a-head full of saline solution, with a remaining little brain floating inside is really, really scary. Altough it would explain a lot, I'll NEVER take a head x-ray.
posted by cardoso at 1:25 AM on June 30, 2006

Huh. I thought it was one-sided.
posted by flabdablet at 4:31 AM on July 1, 2006