Man's brain rewired itself in 19 years after crash

MSNBC ^ | July 3, 2006

[Alouette]

Doctors have proof on how man who was barely conscious for decades woke

Doctors have their first proof that a man who was barely conscious for nearly 20 years regained speech and movement because his brain spontaneously rewired itself by growing tiny new nerve connections to replace the ones sheared apart in a car crash.

Terry Wallis, 42, is thought to be the only person in the United States to recover so dramatically so long after a severe brain injury. He still needs help eating and cannot walk, but his speech continues to improve and he can count to 25 without interruption.

Wallis’ sudden recovery happened three years ago, but doctors said the same cannot be hoped for people in a persistent vegetative state, such as Terry Schiavo, the Florida woman who died last year after a fierce right-to-die court battle. Nor do they know how to make others with less serious damage, like Wallis, recover.

[cyn]

Thanks for your post. Like the article, your nephew's situation shows how much is still unknown about recovery from brain injury.

Interesting that the experts say they don't really know how these things happen, but declare that this most certainly could not have happened in Terri Schiavo's case. Not that any recent tests had been done to check her brain function -- which of course cannot be done at autopsy.

[cyn]

Thanks for your post. Like the article, your nephew's situation shows how much is still unknown about recovery from brain injury.

Interesting that the experts say they don't really know how these things happen, but declare that this most certainly could not have happened in Terri Schiavo's case. Not that any recent tests had been done to check her brain function -- which of course cannot be done at autopsy.

[bvw]

Or of the radical surgery that removes half a brain -- hemispherectomy. That leaves a big empty space.

The brain, as this case at the top of thread shows, is a miracle. No scan does it justice. It is full of surprises.

Ask AntiGuv how empty is his heart? Or perhaps it is too full of himself. The heart is also wondrous. AntiGuv may find his one day. We hope.

[bvw]

Well, the small print is healthier. However the sanest view is that current consent be needed and no forward contract for suicide be legal.

[ClaireSolt]

There seems to be some vague standard of recovery in these cases. If they can't recover, then.... Certainly a family who is providing the care has more say than a family who throws themselves on the public dole. do the later and find yourself on court TV.

[skr]

Name me one person who thought Terry was living a happy life. I never read anyone's post stating such. But I've read plenty who seem to think she didn't have a right to her life, as difficult as it was. A person's will to live has to be extremely strong to go through what she went through for all those years. When she was unable to speak for herself, she deserved the best care until she passed due to natural causes that weren't expedited by an adulterous husband and a lawyer bent on making his mark in legal and legislative history.

[the invisib1e hand]

Yes, since her parents stupidly wanted to keep their eggplant of a daughter around to exploit.

You are the Captain of the Good Ship Moron. If it wasn't so much fun putting you in your place, I wouldn't waste an iota of my existence on you, you poor thing.

[bvw]

Yes, there's a consideration to be made as to who pays and provides. In the Schiavo case her parents, mom and dad and siblings, brother and sister, offered to provide. The Judge ordered her to be starved, while her parents watched helplessly, evilly restrained from providing any drop of water, or even direct company.

In many cases -- such as expereinced by many posters on FR, and everywhere else -- it is the cost and burden of long term care that allows "the process" to go forward. And that process is the removal of food and water. Death by dehydration and stavation while drugged with high doses of pain-killer. Opium weakens the pulse and speeds Death's plow.

That burden and cost -- that, however, is a honest concern. How can it be borne -- we are all not Midas?

[ClaireSolt]

I went through this with a young husband who got a brain tumor. My mother-in-lawa and I disagreed.

[Lunatic Fringe]

Schiavo's higher brain function centers were destroyed, replaced by fluid. She had no will to live.

[bvw]

Whatever happened, I'm sure it was very difficult for you then, and even today in recollection.

[Texas Eagle]

...doctors said the same cannot be hoped for people in a persistent vegetative state, such as Terry Schiavo, the Florida woman who died last year after a fierce right-to-die court battle.

Terri Schindler didn't die, she was killed.

[yevgenie]

Re: Schiavo's higher brain function centers were destroyed, replaced by fluid. She had no will to live.

Pray tell, how are you qualified to make the first assessment? Furthermore, pray tell your reasoning in assertion of the second?

Self bookmark for possible further commentary on CT, MRI, and Brain SPECT (functional analysis).

[Polybius]

The scan on the left is a normal brain. The scan on the right was the remant of Terri Schiavo's brain:

Looks to me as if there wasn't much left to recover.

As a radiologist, the first time I saw those those two CT images used to make that point, I thought to myself, "Now there's a classic example of how the media can and will manipulate information."

The CT slice selected to illustrate "the normal brain" has been taken at the axial level of the frontal horns and the third ventricle.

The CT slice selected to illustrate "Schiavo's brain" was taken at the axial level of the lateral ventricles.

The ventricles are cerebral spinal fluid (CSF) filled cavities in your brain. (In purple in the drawing below.) They are supposed to be there. On CT, CSF is black.

The lateral ventricles are the very long, curved ventricles at the top of the ventricular system. The third ventricle is the little ventricle below the lateral ventricles. The frontal horns are the anterior tips of the lateral ventricles that are seen as little pockets of CSF when you clip them with a third ventricle level CT slice.

So, if you take the CT slice at the third ventricle/ frontal horn level, guess what? There are almost no CSF collections there.

But, when you take a CT slice at the level of the lateral ventricles.....WHOAAA!!!.....Big difference! These are mildly dilated lateral ventricles in a 76 year old.

To a layman, especially if they are shown a slice at the third ventricle level as an example of "what a normal brain should look like", the CT slice selected from the lateral ventricle level makes it look as if there were a huge hole in Granny's brain.

No need to try to euthanize Granny because of those lateral ventricles. She will just hit you over the head with her purse and tell you that she is cutting you out of her will as soon as she calls her lawyer in the morning.

There is no doubt the Schiavo had hydrocephalus (and cortical atrophy too) but I have had patients with just as much hydrocephalus with shunts in place walk in and walk out of our CT room.

Schiavo may have had other issues that would have made her a lost cause but, if I showed a layman third ventricle level CT images of a "normal brain" and then showed the layman lateral ventricle level images of any of your brains, I could very easily convince that layman that a significant chunk of your brain was gone.

[Polybius]

How come the sinuses show in the second scan but not the first? Could be comparing apples and oranges?

Yes. See Post 94.

They compared third ventricle axial level apples with fourth ventricle axial level oranges.

The frontal para-nasal sinuses, however, are a red herring. Frontal sinuses vary in every individual and are sometimes huge and sometimes congenitally absent. Whether you see them or not at a certain axial level is therefore of little significance as an anatomical landmark.

[AntiGuv]

Thanks for the info and based on your comments my earlier remarks were off-base. I haven't seen those scans explained that way before fwiw. Anyhow, sorry if my comments were misleading! I'm gonna go back to my policy of never touching this subject again. :)

[tioga]

Amen.

[CindyDawg]

Thanks for explaining. I still have trouble with just plain ole xrays:')

[Polybius]

Beats me, so here's a normal brain with sinuses:

That would be a normal brain with the slice at the level of the third ventricle and the basal ganglia.

Here is a normal brain with the slice at the level of the lateral ventricles:

If I showed the first image as an example of a "normal" brain and then showed the second image as an example of your brain, I could convince a layman that you had something seriously wrong with your brain.

Schiavo certainly had something wrong with her brain but when the media compared third ventricle level images of a normal brain with lateral ventricle level images of her brain, they were using image manipultion to grossly exaggerate the difference between her brain and a normal brain.

[freedumb2003]

Schiavo may have had other issues that would have made her a lost cause but, if I showed a layman third ventricle level CT images of a "normal brain" and then showed the layman lateral ventricle level images of any of your brains, I could very easily convince that layman that a significant chunk of your brain was gone.

So the MDs and neuroscientists lied on the stand? And the coroners?

Is there are reason you are a radiologist and not an MD? No offense, but is there some chance the MDs and PhDs might have some information you don't? Or do you know more than them and decided to just stop?