lunedì 27 febbraio 2012

Hemispherectomy

After reading the Ben Carson's book, I became interested in hemispherectomy, as in the 1980s he reintroduced this procedure of removing part of the brain in children.

Therefore, as an As student I, in my little, made some researches concerning it. 

Hemispherectomy is the removal of one part of the brain which has been damaged due to illnesses, such as epilepsy. It was introduced in 1988 by Frederic Goltz on cats, and the first surgery on humans was made in 1923 by Walter Dandy. However, the outcomes of this procedure were not successful. It was just after that the Prof. Ben Carson has reintroduced it again that hemispherectomy has become known again, in the 1980s.

Patients who undertake this operation are those who suffer from really debating illnesses, for instance: Hemiplegia, Rasmussen's syndrome, Epilepsy at an advanced state and people who has experienced visual problems. 

Although, it can be practised on both adult and children, hemispherectomy had more successes on children, due to the fact that their brain has generally got more neuroplasticity, allowing the neurones in the part of the hemisphere which has not been taken out to differentiate into neurones of the lost hemisphere, therefore making able the child to function normally. 

However not every patient is then able to recover at 100%, in fact many patients end up with mental, language, movement, humour, and retardation problems, which are usually present even before the surgery. 
Moreover, some people will not be able to talk properly due to the left hemisphere lost. 

Over all, hemispherectomy is a dangerous procedure which can lead to irreversible and permanent damages, but if done it in time on children it can save many life at it has been proved that 52% became seizure free, 9% experienced only rare seizure, a further 30% had >75% reduction in seizure frequency and 9% experienced <75% reduction in seizure, no improvement 6%*.

In conclusion, I have been fascinated by the fact that, though we take out a part of the brain, not just in children as it has been shown by Prof Ben Carson who made hemispherectomy on a patient of 21 years old, that if the brain has been damaged for a long time the other part of the brain will take over it, differienciating neurones in the healthy hemisphere as they were part of the damaged one so to make the individual able to have a normal life. 


*http://brain.oxfordjournals.org

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