Where's My Brain? Woman's Missing Cerebellum Went Unnoticed for 24 Years

[Buster's Uncle]

Where's My Brain? Woman's Missing Cerebellum Went Unnoticed for 24 Years
LiveScience.com
By Bahar Gholipour, Staff Writer  5 hours ago



MRI scans of the patient's brain show a large hole where the cerebellum should be.



Doctors in China were surprised to find that a young woman who had lived a normal life for more than two decades was actually missing an important part of her brain, according to a new report of her case.

The 24-year-old's strange condition was discovered when she went to doctors because of a monthlong bout of nausea and vomiting. The patient told the doctors she had also experienced dizziness her entire life. She didn't start walking until she was four and had never been able to walk steadily.

When the doctors scanned the woman's brain, they found she had no cerebellum, a region of the brain thought to be crucial for walking and other movements. Instead, the scans showed a large hole filled with cerebrospinal fluid.

"CT and MRI scans revealed no remnants of any cerebellar tissues, verifying complete absence of the cerebellum," the doctors wrote in the report, published Aug. 22 in the journal Brain.

The cerebellum, which means "little brain" in Latin, is responsible for coordination and fine movements, such as the movements of the mouth and tongue needed for producing speech. People with damage to this brain area typically experience debilitating motor difficulties. Yet contrary to the doctors' expectations, the Chinese woman's absence of the cerebellum resulted in only mild to moderate motor problems and slightly slurred pronunciation, according to the researchers. "This surprising phenomenon," demonstrates the plasticity of the brain early in life, they wrote.

"It shows that the young brain tends to be much more flexible or adaptable to abnormalities," said Dr. Raj Narayan, a professor of neurosurgery at North Shore University Hospital in New York who wasn't involved with the woman's case. "When a person is either born with an abnormality or at a very young age loses a particular part of the brain, the rest of the brain tries to reconnect and to compensate for that loss or absence," Narayan said.

This remarkable ability of the brain is thought to decline with age. "As we get older, the ability of the brain to tolerate damage is much more limited," Narayan said. "So, for example, in a 60-year-old person, if I took the cerebellum out, they would be severely impaired."

This is not the first case of a person found to be missing the cerebellum. In fact, there have been eight other similar cases reported, the researchers said. However, most cases involved infants or children who also showed severe mental impairment, epilepsy and large structural abnormalities in their brains, and most did not survive the condition.

It is possible that more people are affected by this rare condition but they don't get diagnosed or reported, Narayan said. "In the future, it may become more recognized because of brain imaging," he added.


http://news.yahoo.com/wheres-brain-womans-missing-cerebellum-went-unnoticed-24-125230090.html

[Buster's Uncle]

This woman is living without a cerebellum. How is that possible?
Vox
Updated by Susannah Locke on September 12, 2014, 12:20 p.m. ET @susannahlocke susannah@vox.com



That big black spot is the hole where this woman's cerebellum usually would be.  Yu, F. et al. Brain (2014)



Look at the giant black hole in this woman's brain, above. That's where her cerebellum should be. It's the brain region critical for movement and coordination. And apparently, it's possible for a person to live without it.

In a case study recently published in the journal Brain, a Chinese group of researchers describes a 24-year-old woman who had no idea that there was anything unusual about her brain until she went to the ER one day with symptoms of nausea and vomiting.

Brain scans revealed that she had no cerebellum, as you can see in the picture above. Not only was she alive, but she was mostly healthy except for dizziness and an unsteady gait that's been with her most of her life.

The paper notes that she's one of only nine recorded cases in the medical literature of someone surviving without a cerebellum.

Granted, it's entirely possible that there are other cases out there that have never been diagnosed. Unless someone ends up getting a brain scan or an exceptionally thorough autopsy, a person might never know that a huge chunk of his or her brain was missing.



A different patient, after a hemispherectomy (Yao, N. et al. Neural Plast. 2013: 832473)


This case study in Brain is an excellent example of how surprisingly adaptable the brain can sometimes be, especially with abnormalities that happen earlier in life. Whereas many scientists used to think of the brain as having permanent regions that do very particular tasks, it turns out that many parts of the brain can do all sorts of different tasks — if they have to.

For example, surgeons have sometimes removed half the brain to stop severe recurring seizures in children. That's one version of a procedure called a hemispherectomy. (The cerebellum is left behind in these cases.)

After the surgery, the remaining brain cells can sometimes take over many of the functions that had previously been performed by the removed parts. Children's brains are especially malleable in this regard, compared with adults'. If a hemisphere is removed, some children may lose movement on the opposite side of their bodies, but many are still able to normally walk and talk — and they keep their personality, too.

H/t Helen Thomson for her New Scientist story that called my attention to this cerebellum paper.


http://www.vox.com/xpress/2014/9/12/6136647/cerebellum-missing-brain-woman-explained-hemispherectomy