{"id":2798,"date":"2012-04-03T07:15:26","date_gmt":"2012-04-03T06:15:26","guid":{"rendered":"http:\/\/emilkirkegaard.dk\/en\/?p=2798"},"modified":"2012-04-03T07:25:14","modified_gmt":"2012-04-03T06:25:14","slug":"re-why-would-you-remove-half-a-brain-the-outcome-of-58-children-after-hemispherectomy%e2%80%94the-johns-hopkins-experience-1968-to-1996","status":"publish","type":"post","link":"https:\/\/emilkirkegaard.dk\/en\/2012\/04\/re-why-would-you-remove-half-a-brain-the-outcome-of-58-children-after-hemispherectomy%e2%80%94the-johns-hopkins-experience-1968-to-1996\/","title":{"rendered":"Re: Why Would You Remove Half a Brain? The Outcome of 58 Children After Hemispherectomy\u2014The Johns Hopkins Experience: 1968 to 1996"},"content":{"rendered":"

http:\/\/en.wikipedia.org\/wiki\/Hemispherectomy<\/a><\/p>\n

http:\/\/en.wikipedia.org\/wiki\/Hemiplegia<\/a><\/p>\n

Paper: Why Would You Remove Half a Brain The Outcome of 58 Children After Hemispherectomy\u2014The Johns Hopkins Experience 1968 to 1996<\/a><\/p>\n

This is really strange but also interesting!<\/p>\n

\n

ABSTRACT.<\/strong> Purpose. To report the outcomes of the
\n58 hemispherectomies performed at Johns Hopkins be-
\ntween 1968 and January 1996.
\nMethods. Charts were reviewed of the 58 hemi-
\nspherectomies performed at Johns Hopkins Medical In-
\nstitutions by the Pediatric Epilepsy Group during the
\nyears 1968 to 1996. Twenty-seven operations were done
\nfor Rasmussen\u2019s syndrome, 24 operations for cortical dys-
\nplasias\/hemimegalencephalies, and 7 for Sturge-Weber
\nsyndrome or other congenital vascular problems. Seizure
\ncontrol alone did not seem to adequately describe the
\noutcomes of the procedure. Therefore, a score was con-
\nstructed that included seizure frequency, motor disabil-
\nity, and intellectual handicap. This burden of illness
\nscore better described the child\u2019s handicap before and
\nafter surgery.
\nResults. <\/strong>Perioperative death occurred in 4 out of 58
\nchildren. Of the 54 surviving children, 54% (29\/54) are
\nseizure-free, 24% (13\/54) have nonhandicapping seizures,
\nand 23% (12\/54) have residual seizures that interfere to
\nsome extent with function. Reduction in seizures was
\nrelated to the etiology of the unilateral epilepsy. Eighty-
\nnine percent of children with Rasmussen\u2019s, 67% of those
\nwith dysplasias, and 67% of the vascular group are sei-
\nzure-free, or have occasional, nonhandicapping seizures.
\nAll operations were considered by the parents and the
\nphysicians to have been successful in decreasing the
\nburden of illness. In 44 the procedure was very success-
\nful, in 7 it was moderately successful, and in 3 it was
\nminimally successful. Success was related to the etiology,
\nand early surgery was preferable.
\nConclusion.<\/strong> Hemispherectomy can be a valuable pro-
\ncedure for relieving the burden of seizures, the burden of
\nmedication, and the general dysfunction in children with
\nsevere or progressive unilateral cortical disease. Early
\nhemispherectomy, although increasing the hemiparesis
\nin children with Rasmussen\u2019s syndrome, relieves the
\nburden of constant seizures and allows the child to re-
\nturn to a more normal life. In children with dysplasias,
\nearly surgery can allow the resumption of more normal
\ndevelopment. Pediatrics 1997;100:163\u2013171; hemispherec-
\ntomy, burden of illness, epilepsy surgery, quality of life.<\/p>\n

\n

Speculation<\/strong>
\nWhy should removal of half a brain be of benefit to
\na child? Decrease in constant, uncontrollable seizures
\nand the attendant decrease in medications with their
\nside-effects may be part of the reason. However, it is
\ntempting to speculate, that the continuous electrical
\nactivity of these severely dysfunctional hemispheres
\ninterferes with the function of the other, more nor-
\nmal hemisphere. This might explain why motor
\nfunction improves after hemispherectomy and why
\nlanguage recovers after removal of the dysfunctional
\nleft hemisphere,
\n26
\nbut does not seem to fully transfer
\nbefore surgery. Perhaps it also partially explains in-
\ntellectual improvement in these children after re-
\nmoval of half of the cortex. We are awed by the
\napparent retention of memory after removal of half
\nof the brain, either half, and by the retention of the
\nchild\u2019s personality and sense of humor.<\/strong> Yet we look
\nforward to the time when there are less mutilating
\napproaches to these problems. Until then it seems
\nthat half of a brain is less burdensome to these chil-
\ndren than a whole brain where one side is badly
\nmisfiring.<\/p>\n

–<\/p>\n

The more interesting thing was that these people didnt get personality changes or memory loss. How can that be? I have a theory. Think of RAID (RAID 1) systems for computers<\/a>. The idea is that the brain has a similar mirror-setup. It may compartmentalize the functions, but the information is stored in both brains.<\/p>\n

This theory has the added benefit of also explaining why people that get a Corpus callosotomy<\/a> remain roughly the same person in both brains even tho they are independent. The reason is that they have access to broadly the same information.<\/p>\n

http:\/\/en.wikipedia.org\/wiki\/Split-brain#Control<\/a><\/p>\n

In general, split-brained patients behave in a coordinated, purposeful and consistent manner, despite the independent, parallel, usually different and occasionally conflicting processing of the same information from the environment by the two disconnected hemispheres. When two hemispheres receive competing stimuli at the same time, the response mode tends to determine which hemisphere controls behavior.[11]<\/a><\/sup> Often, split-brained patients are indistinguishable from normal adults. This is due to the compensatory phenomena; split-brained patients progressively acquire a variety of strategies to get around their interhemispheric transfer deficits.<\/p>\n","protected":false},"excerpt":{"rendered":"

http:\/\/en.wikipedia.org\/wiki\/Hemispherectomy http:\/\/en.wikipedia.org\/wiki\/Hemiplegia Paper: Why Would You Remove Half a Brain The Outcome of 58 Children After Hemispherectomy\u2014The Johns Hopkins Experience 1968 to 1996 This is really strange but also interesting! ABSTRACT. Purpose. To report the outcomes of the 58 hemispherectomies performed at Johns Hopkins be- tween 1968 and January 1996. Methods. Charts were reviewed of […]<\/p>\n","protected":false},"author":17,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1727,1653],"tags":[1886,1885,1190],"class_list":["post-2798","post","type-post","status-publish","format-standard","hentry","category-medicine","category-psychology","tag-hemispherectomy","tag-mind-philosophy","tag-split-brain","entry"],"_links":{"self":[{"href":"https:\/\/emilkirkegaard.dk\/en\/wp-json\/wp\/v2\/posts\/2798","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/emilkirkegaard.dk\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/emilkirkegaard.dk\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/emilkirkegaard.dk\/en\/wp-json\/wp\/v2\/users\/17"}],"replies":[{"embeddable":true,"href":"https:\/\/emilkirkegaard.dk\/en\/wp-json\/wp\/v2\/comments?post=2798"}],"version-history":[{"count":3,"href":"https:\/\/emilkirkegaard.dk\/en\/wp-json\/wp\/v2\/posts\/2798\/revisions"}],"predecessor-version":[{"id":2804,"href":"https:\/\/emilkirkegaard.dk\/en\/wp-json\/wp\/v2\/posts\/2798\/revisions\/2804"}],"wp:attachment":[{"href":"https:\/\/emilkirkegaard.dk\/en\/wp-json\/wp\/v2\/media?parent=2798"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/emilkirkegaard.dk\/en\/wp-json\/wp\/v2\/categories?post=2798"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/emilkirkegaard.dk\/en\/wp-json\/wp\/v2\/tags?post=2798"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}