The term Brain amputation Does not exist in this form in medicine.Colloquially he describes the Removal of the brainwhat would obviously not be compatible with life. In neurosurgery, however, under certain circumstances an intervention is performed that is popularly believed to be a Brain amputation comes relatively close - the Hemispherectomy. This is a hemisphere, so either the left or right hemisphere, away.
Since from the Removal of one side of the brain serious and, depending on the age of the person concerned, often permanent persistent functional failures result, represents the partial Brain amputation in the sense of a hemispherectomy, always one Ultima ratio (last possible solution). Therefore, if possible, use less radical approaches such as removing a single lobe of the brain (Lobectomy) or cutting through the so-called bar (Callosostomy), which connects the two halves of the brain, is preferably used. Finally, there are new methods in which the affected hemisphere is left completely in the skull and is only shielded from the rest of the brain. This procedure is known as a functional hemispherectomy.
Diseases that can induce the neurosurgeon to consider a hemispherectomy (partial brain amputation) include, in particular, severe epilepsy of various causes. An important clinical picture that such epilepsy can bring with it is Sturge-Weber syndrome. This is a congenital disease from the group of so-called neurocutaneous phacomatoses, which is characterized by benign cavity tumors in the brain and reddish stains in the face. Another possible reason is the so-called Rasmussen's encephalitis in question. This is a rapidly progressing, extensive inflammation of the cerebral cortex that is strictly limited to one half of the brain.
Read more about this under Encephalitis
Requirement for considering a Brain amputation The hemispherectomy type is that the disease is almost only one of the two halves of the brain concerns and that all other conceivable treatment options have already been unsuccessful or are to be regarded as futile. It is also important to weigh the functional failures described below against the benefits of the intervention. The following applies - the younger the patient, the better they will likely get after the hemispherectomy (partial brain amputation) the functional losses suffered again by training the others Hemisphere can compensate.
The Removal of a complete half of the brain (unilateral brain amputation) at hemispherectomy leads to serious Functional failures after the operation. The centers for certain skills are often only in one of the two halves of the brain.
The Language center for example, is found in most people's left hemisphere (hemisphere) while the spatial imagination mostly through the right hemisphere is represented. In addition, in healthy people, the two halves of the brain control each Motor skills and sensory skills the opposite half of the body. So it comes after a right-sided brain amputation to Paralyzes and failures the sensitivity or the eyesight on the left side and vice versa. The functional restrictions are correspondingly smaller after removing only individual brain lobes (Lobectomy).
Due to the severe functional failures described above following a partial Brain amputation Such an intervention should only be carried out in patients for whom, on the one hand, no promising alternative treatment option is available and, on the other hand, there is a prospect that the partial Brain amputation strong improvements in the symptoms of the disease and thus an overall Increase in quality of life can be achieved.
In fact, many patients benefit with it therapy-resistant epilepsy, especially if this one Sturge Weber Syndrome underlies, considerably from one partial brain amputation. The frequency and intensity of epileptic seizures decrease while the intellect and ability to communicate increase. Especially young patients up to elementary school age are suitable patients for such an intervention, as it is still sufficient for them Ability to restructure brain tissue is available. So after the Hemispherectomy or the Lobectomy the half of the brain remaining in the skull or the remaining brain lobes at least partially take over the functions of the removed tissue. This is however intensive training This must be started under the supervision of experts and continued over the long term in order to counteract the consequences of brain amputation. In this way, under certain circumstances, compensation for all functional failures can even be achieved, so that the patient can ultimately live completely without failures in adulthood.
The removal of the so-called focus, i.e. the lobe or half of the brain from which the epileptic seizures originate, should not only be viewed as a symptomatic treatment. This means that the seizures are not only one extremely uncomfortable symptom of an illness, but also other symptoms themselves Brain damage cause. This damage is insignificant for most epileptics because they are treated with Anti-epileptic drugs are often completely seizure-free or have only a few seizures per year. In patients with Rasmussen's encephalitis or Sturge Weber Syndrome on the other hand, the seizures occur much more frequently and can thus permanently lead to structural brain damage. Therefore, with these diseases one becomes partial Brain amputation rather considered.
One partial Brain amputation can hardly be effectively prevented, since the clinical pictures in which such an intervention can be carried out are congenital or of an unclear cause.
The Sturge Weber Syndrome is based on one somatic mutation a certain DNA sequence. The term "somatic" describes here that the mutation did not arise in the germ cell of a parent, but only after fertilization in the course of the development of the fetus or embryo. For this reason, no accumulation of the disease can be observed within certain families, as is the case with so-called Germline mutations the case is. The mutation already exists in the germ cell of one of the parents and is therefore passed on.
The cause of the Rasmussen's encephalitis has not yet been conclusively clarified. It is considered certain that this disease leads to rapid, serious and sudden (brilliant) Activation of the immune system comes in the brain. However, it is still unclear whether the structures that are attacked by the immune system are the body's own structures or components unidentified pathogen acts. As long as this question has not been clarified, there is therefore no prospect of effective prophylaxis.
The fact that the prophylaxis of the diseases mentioned turns out to be practically impossible is invalidated by the extremely low frequency of the same. Only about one in 1 million people will develop one in their lifetime Rasmussen's encephalitiswhile that Sturge Weber Syndrome occurs in about one in 40,000 births.