A man with a cavity in his mind

Scans revealed a cavity filled with water in the brain of a normal person

Scans revealed a cavity filled with water in the brain of a normal person
Three years ago, a 44-year-old man was admitted to the hospital in Marseille, France, who complained of weakness in his left leg. He had no idea what the doctors would discover as the source of his problem: a huge pocket of fluid where most of his brain should be...
Normally, fluid constantly circulates through the brain and drains into the body's transport system. In this case, however, the patient's drainage tubes were created, leading to a build-up of fluid in the cavities and expansion of the skull due to a large volume of fluid exerting pressure on it. This pressure caused the brain to compress into a narrow layer around the fluid. The doctors report this medical case in the Lancet journal.
"We were very surprised when we first looked at the CT scans," says Lionel Pouillet, a neurologist at the Mediterranean University in Marseille. "The brain was much, much smaller than normal." At the same time, further tests conducted afterwards showed that this patient, suffering from such a large amount of water in his brain, had an IQ of 75, a measure indicating the low end of the normal range of intelligence.

The patient is a married man with two children who is employed as a public servant. His problems with his left leg were neurological symptoms of his condition, Pouillet says.
Water on the brain
The general phenomenon caused by the accumulation of fluid in the brain cavities called hydrocephalus or "water on the brain" is a relatively common phenomenon, affecting 1,000 in XNUMX people. It is mostly common among children but can also appear in adults.
To release the fluid trapped in the brain, doctors insert a tube known as a shunt, which allows the fluid to drain and leak into the bloodstream and central nervous system. Through this treatment, most patients lead a relatively normal lifestyle. However, neurological problems and other complications, such as brain infection and problems related to the tube itself, are also common. If the condition is left untreated, it may worsen to the point of death.
It is likely that the patient in this case had hydrocephalus from birth, says Pouillet. From a review of the medical file it was found that he was treated with a leaking tube at the age of 6 months, and again at the age of 14 years. However, without further neurological problems, the decades passed without examining his condition and without knowing the degree of fluid accumulation.
The fact that his medical history indicates normal neurological development is unusual, says Pouillet. "So far we have not encountered such a case. As far as we know it is unique. We have never encountered such a severe case of hydrocephalus."
Many medical conditions also lead to brain shrinkage, including atrophy (degeneration) of the brain as a result of Alzheimer's disease, explains Pouillet. "However, in these cases, mental abilities are usually affected." For example, people suffering from microcephaly - a condition in which the size of the head and brain is reduced (but the brain structure is normal) - may suffer from epilepsy, visual and hearing impairment, cerebral palsy and autism.
Happily, the patient reported here made a full recovery following the treatment, reports Pouillet, although brain scans taken after the fluid was drained showed no change in the size of his brain.

The news in its entirety appears in Nature News