Bizarre patient: he lives almost without a brain

A 44-year-old man presents to the Timone hospital in Marseille for a weakness in the left leg which has persisted for two weeks. On this day in 2007, the doctors surely did not suspect that they had just met one of the most surprising patients of their career. In clumsy words, he tells them that he once had a problem with the same leg when he was 14 — it wasn’t moving properly. He also states that he has several problems to the brain since he was a baby.

When fluid infiltrates the brain

Transferred to the service of neurology from the hospital, the patient spends a MRI of the brain. The pictures are impressive! Unlike a normal brain, which takes up most of the volume available from the skull, his is pushed out to the sides, occupying only a tiny strip along the wall of the skull. The third and fourth ventricles as well as the lateral ventricle take up an inordinate amount of space in the brain, filled with an abnormal quantity of liquid cerebrospinal.

For doctors, it is a hydrocephalus non-communicating; a condition with which the patient was born and for which he underwent a first operation at the age of six months: the placement of a shunt. The shunt diverts excess fluid from the brain to theabdomen where it will be reabsorbed. A readjustment of this shunt relieved his leg when he was 14 years old.

Despite his unusual brain, the patient has a normal life. He is married, has two children and works as a civil servant and has no neurological symptoms. His intellectual abilities are diminished, he has an IQ (a contested way of measuring an individual’s intelligence) of 75 when the average is around 90-100. After an operation which aims to facilitate the circulation of cerebrospinal fluid between the different parts of the brain, the condition of his leg is improving. The patient was released from the hospital and went on with his life… with a “swimming pool” in place of the brain.