How Hemispherectomy Works

How Hemispherectomy Works Dr. Travis Stork: Honest’s Neurosurgeon Dr. Aaron Cohen from Clarian Health Methodist Hospital in Indianapolis is here with us. Thank you so much for joining us. Remarkable footage but explain to everyone what was going on with the Honest brain that required this magnificent surgery. Dr. Aaron Cohen: Well, Honest is what something from disease process called hemimegalencephaly. That means half of the whole brain, in other words the right hemisphere for him was malformed and was growing larger than normal. It was causing almost hundred seizures a day at times as you can see in this model. The seizures were transferred from this abnormal hemisphere to the normal hemisphere on the left side. Dr. Travis Stork: So, when everyone is looking at these normally bright lights in the brain means good things. Think of this as seizure activity as you are looking at this and every now and then it crosses into the good side of the brain causing on to have a seizure. Dr. Aaron Cohen: That is correct. All these little lightnings are abnormal. The over discharge of the brain with no purpose. And when they get transferred to the normal side, it causes a generalized seizure and the horrible shakings that you see causes brain damage and makes the child dysfunctional for almost an hour later. Dr. Jim Sears: If that’s happening all the day long, there’s no way a child can develop properly. Dr. Aaron Cohen: Absolutely not. Dr. Jim Sears: Eat and grow, there’s no way. Dr. Travis Stork: So, good brain and bad brain. If you didn’t do the surgery you did, Honest would’ve had no hope. So, what did you do in the operating room? Dr. Aaron Cohen: Not only obvious to deny how the hope that growing up, he would have died from a fatal seizure at a very young age, no chance of life. That’s not good. So, we’ve got to do something about it. So, what we would like to do in surgery is disconnect this bad hemisphere from the good hemisphere so we can let this good hemisphere take over both hemispheres and make the child grow and become a very functional person in the future. Dr. Travis Stork: So, there are two amazing things about the story. Number one, your actually surgery which I want you to show us what you did but also the fact that we can live with one-half of the brain basically. Dr. Aaron Cohen: Exactly. Dr. Travis Stork: Walk us through and how you get to that area to disconnect the tube inside of the brain. Dr. Aaron Cohen: So, for us to get into Honest’s middle of the brain to disconnect this mother cable, we had to do some tricks surgically. What we did is removed the small part of the brain here which actually is just smaller than that and in this ways we were able to get into the middle part of the brain to disconnect the two hemispheres. And therefore we were not only able to disconnect the corpus callosum, there are other connections that we disconnect. And this hemisphere stays there but really does nothing. Dr. Jim Sears: So, here you remove and basically you’ve disconnecting half of the brain. Explain how would a child’s ability is there to have the left side take over the entire function of the brain. How that is happen? Dr. Aaron Cohen: As we know, normally the right brain controls the left side. The left brain controls the right side. Dr. Jim Sears So now his left brain has to control both sides. Dr. Aaron Cohen: Both sides. That is extremely amazing. Why? Because this is the first law of evolution of the brain that the left has to control right. How do as it is happen that in a child, both sides have controlled by the hemisphere, we still don’t know but we know it happens. We know that Honest can grow very well and we know he is going to be great. Dr. Jim Sears: That’s great. Dr. Travis Stork: So, after this miraculous surgery by Dr. Cohen, we have Honest with us today. Does everyone want to meet him? Come on out Honest. So we’re here with Honest’s mom Aveena and how is he doing? Aveena: It is a miracle. Honest is a normal baby. He learned more in the months after the surgery then he did in the paste. So, he is a normal baby. Dr. Travis Stork: Well, amazing surgery. And he’s prognosis now. Dr. Aaron Cohen: Is excellent. It is amazing before surgery, he could not hold his head and he could not sit, he could not crawl. Within two weeks, he has been able to hold his head, to crawl and he has been able to feed so much that he has almost gained half of his weight that’s really to have.