Definition
The term brain amputation does not exist in this form in medicine. In colloquial language it describes the removal of the brain, which would not be compatible with life. In neurosurgery, however, under certain circumstances an operation is performed which is relatively close to the common idea of a brain amputation – the hemispherectomy.
This involves the removal of a hemisphere, i.e. either the left or right hemisphere of the cerebrum. Since the removal of one hemisphere results in severe and, depending on the age of the patient, often permanent functional deficits, a partial brain amputation in the sense of a hemispherectomy always represents a last resort (last possible solution). If possible, less radical procedures such as the removal of a single lobe of the brain (lobectomy) or the cutting of the so-called bar (callosostomy), which connects the two halves of the brain, are therefore preferred. Finally, new procedures exist in which the affected cerebral hemisphere is left completely inside the skull and is only shielded from the rest of the brain. These procedures are known as functional hemispherectomy.
Cause
Among the diseases that can lead the neurosurgeon to consider a hemispherectomy (i.e. a partial brain amputation) are mainly severe epilepsies of various causes. An important clinical picture that can result in such epilepsy is Sturge Weber syndrome. This is a congenital disease from the group of so-called neurocutaneous phacomatoses, which is characterized by benign tumors in the brain and reddish port-wine stains on the face.
Another possible cause is the so-called Rasmussen encephalitis. This is a rapidly progressing, extensive inflammation of the cerebral cortex, which is strictly limited to one hemisphere of the brain. The precondition for considering a brain amputation of the hemispherectomy type is that the disease affects almost exclusively one of the two hemispheres of the brain and that all other conceivable treatment options have already been unsuccessful or must be considered hopeless. It is also important to weigh the functional deficits described below against the benefits of the intervention. The younger the patient, the better the chances are that after hemispherectomy (partial brain amputation) he will be able to compensate for the loss of function by training the remaining hemisphere.
