http://www.newscientist.com/article.ns?id=dn12301&feedId=online-news_rss20

A man with an unusually tiny brain manages to live an entirely normal 
life despite his condition, which was caused by a fluid build-up in 
his skull.

Scans of the 44-year-old man's brain showed that a huge fluid-filled 
chamber called a ventricle took up most of the room in his skull, 
leaving little more than a thin sheet of actual brain tissue (see 
image, right).

"It is hard for me [to say] exactly the percentage of reduction of the 
brain, since we did not use software to measure its volume. But 
visually, it is more than a 50% to 75% reduction," says Lionel 
Feuillet, a neurologist at the Mediterranean University in Marseille, 
France.

Feuillet and his colleagues describe the case of this patient in The 
Lancet. He is a married father of two children, and works as a civil 
servant.

Not retarded
The man went to a hospital after he had mild weakness in his left leg. 
When Feuillet's staff took his medical history, they learned that, as 
an infant, he had had a shunt inserted into his head to drain away 
hydrocephalus - water on the brain.

The shunt was removed when he was 14. But the researchers decided to 
check the condition of his brain using computed tomography (CT) 
scanning technology and another type of scan called magnetic resonance 
imaging (MRI). They were astonished to see "massive enlargement" of 
the lateral ventricles - usually tiny chambers that hold the 
cerebrospinal fluid that cushions the brain.

Intelligence tests showed the man had an IQ of 75, below the average 
score of 100 but not considered mentally retarded or disabled.

"The whole brain was reduced - frontal, parietal, temporal and 
occipital lobes - on both left and right sides. These regions control 
motion, sensibility, language, vision, audition, and emotional and 
cognitive functions," Feuillet told New Scientist.

Brain adaptation
The findings reveal "the brain is very plastic and can adapt to some 
brain damage occurring in the pre- and postnatal period when treated 
appropriately," he says.

"What I find amazing to this day is how the brain can deal with 
something which you think should not be compatible with life," 
comments Max Muenke, a paediatric brain defect specialist at the 
National Human Genome Research Institute in Bethesda, Maryland, US.

"If something happens very slowly over quite some time, maybe over 
decades, the different parts of the brain take up functions that would 
normally be done by the part that is pushed to the side," adds Muenke, 
who was not involved in the case.



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