Jul. 30th, 2007

orleanz: (Default)
The redundancy of much of the brain (most of the cerebellum and cerebral hemispheres) is remarkable. The brain stem and the deeper structures (thalamus, basal ganglia) are less tolerant and more ''hardwired'', and it''s essential in this business to know what''s hard wired and what''s not. Most of the brain isn''t hardwired. For example, it''s well known (in my experience and in the experience of other neurosurgeons) that removal of most of both cerebellar hemispheres (because of strokes or tumors) causes no discernable long-term disability. I have many patients with large portions of their cerebellums missing who are completely normal. The invariable assumption- ''some other part of the brain took over''- is merely an inference. We generally have no actual evidence what, if anything in the brain, ''took over''. Perhaps the inference is because we start with a materialist bias, and we can''t imagine neurological function without an identifiable region of the brain to cause it. We really don''t understand a lot of whatever correlation exists between neuroanatomy and neurological function.

Many years ago I removed a tumor from the left frontal lobe of a patient. Adequate resection of the tumor required removal of most of the lobe, but I had to take care to avoid injury to the speech areas and the motor areas of the frontal lobe, located posteriorly. I did the surgery under local anesthesia (for the scalp- the brain has no sensation of pain) so I could electrically ''map'' the speech and motor areas during the surgery and avoid injury. As I was removing nearly the entire left frontal lobe, the patient (under the surgical drapes) and I had a conversation, discussing life in general, philosophy, family stuff, etc. She never turned an hair as I was removing large portions of her brain.

http://mindfulhack.blogspot.com/2007/07/just-how-much-brain-do-you-need-could.html

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