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An Amazing Brain Story

Natalie Staats Reiss, Ph.D. Updated: Jul 24th 2007

Another amazing example of the concept of "neuroplasticity" is in the news lately. "Neuroplasticity" refers to our brain's flexible ability to grow and assume new shapes, and thereby enable memory and learning. This skill can result in a jaw-dropping ability to compensate for brain damage, as neurons (cells of the brain and spinal cord) are "reprogrammed" in take over for other damaged cells.

The most recent issue of the medical journal The Lancet (July 21, Vol 370, pg 262) describes a case of a 44-year-old French man who developed hydrocephalus (an excessive accumulation of cerebrospinal fluid, or CSF, in the brain) as a very young infant. He was treated with a shunt (a small tube that diverts the flow of CSF to another part of the body) that was subsequently removed at age 14. The man then went on to lead a "normal" life, obtaining a job as a civil servant, marrying, and having two children.

He recently visited doctors complaining of "mild weakness" in his left leg. His doctors used brain imaging technology (MRI and CT scans) to help them pinpoint the cause of the weakness. It would have been interesting to see their stunned reactions upon examining the results of the scans (the patient's CT results are shown below on the left).

Normal and hydrocephalic brains

Images obtained from http://drx.typepad.com/psychotherapyblog/2007/07/man-with-tiny-b.html

In clinical terms, the scans showed "massive enlargement" of the ventricles. The ventricles are four large chambers of the brain which are filled with CSF, which supports and cushions the brain, delivers nutrients, and removes waste. In the set of scans above on the left, the large black areas are the patient's ventricles, which have clearly expanded and compressed the rest of the brain into a small layer. The images on the right show the normal size of the ventricles (the butterfly shaped structure in the top right scan).

It doesn't take a neurologist to see the dramatic differences between the two sets of scans. In essence, this man went through life with a very small amount of functioning brain. Even more amazingly, the man's IQ score is 75, which according to the DSM-IV TR (the manual used by mental health clinicians to diagnose disorders) is on the high end of mild mental retardation. Clearly, the neurons that were spared being squished by the fluid-filled ventricles "took over" the operations for the neurons that were damaged. I am simply blown away that this man is able to function... it's a fascinating real world example of neuroplasticity in action.

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