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▎The content team editor of WuXi AppTec until he was 13 years old, Daniel Carr didn't know that part of his brain was missing.
Now, he is 22 years old and leads a very normal life.
This is a rare case study recently published in The Lancet-Neurology.
In the opinion of Daniel’s treatment team, “This case highlights the extraordinary potential of brain remodeling, especially in early life.
” Screenshot source: The awkward right hand on The Lancet Neurology baseball field first noticed Daniel’s body abnormality.
At a baseball game.
Daniel's coach noticed that although his tactics were effective, they were unusual.
Daniel wears a glove on his right hand, but when the baseball comes oncoming, he always takes off the glove, grabs the ball with both hands, throws the ball with his left hand, and then puts the glove back on his right hand again.
"Daniel can catch and throw the ball faster than most kids.
But I have never seen a left hand like this.
It's incredible.
" Talking to the coach made his mother Kellie Carr realize that Daniel There are indeed many physical "quirks".
For example, on weekdays, when he used his right hand, he was often a little awkward; when he was younger, when he was about one year old, he always walked to the left-but this phenomenon was very short-lived.
Moreover, Daniel has always been left-handed, which was already obvious in his infancy.
In order to troubleshoot health problems, Kelly took Daniel for medical treatment many times.
They went to see a pediatrician, orthopedic doctor, physical therapist.
.
.
but they all returned to no avail.It was not until the fall of 2012, when Daniel was 13 years old, when they found Dr.
Nico Dosenbach, a professor of neurology at the University of Washington School of Medicine, and they received a preliminary diagnosis of tremor.
Dr.
Nico told them, “We still need to do more tests, but we believe that Daniel’s stroke in his infancy is the cause of all this.
” Image source: 123RF neglected stroke in the newborn period As a mother, Kylie never knew Daniel also suffered a stroke.
When reviewing Daniel's medical history in detail, the medical team noticed that Daniel had experienced 3 weeks of viral infection when he was born.
Although the source of the infection is unknown, Daniel had difficulty breathing, eating, vomiting, diarrhea, and persistent sleepiness.
He spent about a week in the neonatal intensive care unit and received intravenous fluids and blood transfusions.
In the end, he recovered and was discharged without any serious health problems.
Although there were no test results suggesting signs of stroke at the time, Dr.
Nico pointed out that “newborn infections will greatly increase the risk of stroke in children, but they usually have more obvious symptoms.
” In order to confirm the diagnosis of stroke, the clinic team responded Daniel underwent a more extensive physical examination, including neuroimaging.
"Among children who have not died or experienced severe physical and mental disabilities, this is the most serious stroke I have ever seen.
" Daniel's MRI scan showed that a severe stroke during his infancy caused injuries to both sides of his brain.
There is a significant loss of tissue in areas of the brain related to thinking, emotion, memory, and advanced functions.
However, Daniel does not seem to have any cognitive, memory or emotional problems.
In the two brain hemispheres, there are also asymmetric injuries in the movement-related areas, which can affect skills such as movement and balance.
Usually, most strokes will damage one side of the brain, and the consequences of bilateral injuries will be more serious.
"Daniel's degree of injury may be on the edge of adapting to life.
" Dr.
Nico exclaimed. Amazing brain remodeling After confirming the diagnosis of stroke, Dr.
Nico, with the consent of Daniel and his family, carried out a series of motor and neurobehavioral tests and imaging studies on him.
Current neurobehavioral tests show that Daniel's score is generally within the normal range.
However, the motor skills assessment showed that Daniel's right upper limb was weaker in strength, speed and agility compared to the left upper limb.
Comparing Daniel's brain imaging data with the results of other young people, it is found that "part of Daniel's brain structure has disappeared, and he is missing almost a quarter of the cerebral cortex (cortex).
" ▲Daniel (left) and Dr.
Nico (Right) Brain image.
The dark area of Daniel’s brain image reflects the loss of a large number of tissues in the left and right hemispheres (picture source: Dosenbach lab).
The imaging examination also shows that in Daniel’s brain, the voids formed by the necrotic tissue are filled with cerebrospinal fluid, which can buffer and protect the brain from harm.
At the same time, it can also transport nutrients to the tissues and remove metabolic waste.
Neurons are also "connected" again, which promotes the maintenance of brain function.
Starting from the vicinity of healthy tissues, the "remaining" tissues after injury gradually restore interconnection.
Dr.
Nico said: "Our findings show that the brain is very tenacious in reorganizing and restoring functions.
Future research on the function of the lost tissue may provide more insights.
" American Heart Association data shows that every 4,000 newborns One will suffer a stroke.
"The health outcomes of these children vary.
About a quarter of lucky babies have healthy motor and cognitive functions.
" Dr.
Nico said, "In early childhood, the brain can continue, faster, and more completely.
In contrast, adult stroke can cause severe dysfunction and even death, which is difficult to recover.
But we are just beginning to understand the mechanism behind these phenomena.
"Normal life is the best arrangement for this special The case also shows that the prognosis of early stroke is difficult to predict accurately.
In the view of the medical team, “If Daniel is found to have a brain injury in his infancy, his family may be told that he will face severe developmental and cognitive delays.
He may not have the opportunity to go to school and participate in sports normally.
” Despite the right hand Not flexible enough, Daniel's life is normal.
He goes to school in the block, hangs out with friends, and plays baseball, football, and football from kindergarten to high school.
He has also obtained a university degree and is working on car repair technology.
"I didn't even know that he had a stroke.
" In retrospect, Kelly was shocked and grateful.
"Perhaps for him, a normal life is the best destiny arrangement.
" This is what Daniel thought.
"Every day, I have to think about it to operate smoothly with
my right hand.
But the last thing I want is that everyone treats me as a patient, and everything is fine.
" Title picture source: 123RF Reference [1] Timothy O Laumann, et al.
, (2021).
Brain network reorganisation in an adolescent after bilateral perinatal strokes.
The Lancet Neurology, DOI: https://doi.
org/10.
1016/S1474-4422(21)00062-4[2] Brain rewires itself after injury'on the edge of what's compatible with life'.
Retrieved March 24, 2021, from https://medicalxpress.
com/news/2021-03-brain-rewires-injury-edge-compatible.
html Note: This article aims to Introduce medical and health research progress, not a treatment plan recommendation. If you need guidance on treatment plans, please go to a regular hospital for treatment.
Now, he is 22 years old and leads a very normal life.
This is a rare case study recently published in The Lancet-Neurology.
In the opinion of Daniel’s treatment team, “This case highlights the extraordinary potential of brain remodeling, especially in early life.
” Screenshot source: The awkward right hand on The Lancet Neurology baseball field first noticed Daniel’s body abnormality.
At a baseball game.
Daniel's coach noticed that although his tactics were effective, they were unusual.
Daniel wears a glove on his right hand, but when the baseball comes oncoming, he always takes off the glove, grabs the ball with both hands, throws the ball with his left hand, and then puts the glove back on his right hand again.
"Daniel can catch and throw the ball faster than most kids.
But I have never seen a left hand like this.
It's incredible.
" Talking to the coach made his mother Kellie Carr realize that Daniel There are indeed many physical "quirks".
For example, on weekdays, when he used his right hand, he was often a little awkward; when he was younger, when he was about one year old, he always walked to the left-but this phenomenon was very short-lived.
Moreover, Daniel has always been left-handed, which was already obvious in his infancy.
In order to troubleshoot health problems, Kelly took Daniel for medical treatment many times.
They went to see a pediatrician, orthopedic doctor, physical therapist.
.
.
but they all returned to no avail.It was not until the fall of 2012, when Daniel was 13 years old, when they found Dr.
Nico Dosenbach, a professor of neurology at the University of Washington School of Medicine, and they received a preliminary diagnosis of tremor.
Dr.
Nico told them, “We still need to do more tests, but we believe that Daniel’s stroke in his infancy is the cause of all this.
” Image source: 123RF neglected stroke in the newborn period As a mother, Kylie never knew Daniel also suffered a stroke.
When reviewing Daniel's medical history in detail, the medical team noticed that Daniel had experienced 3 weeks of viral infection when he was born.
Although the source of the infection is unknown, Daniel had difficulty breathing, eating, vomiting, diarrhea, and persistent sleepiness.
He spent about a week in the neonatal intensive care unit and received intravenous fluids and blood transfusions.
In the end, he recovered and was discharged without any serious health problems.
Although there were no test results suggesting signs of stroke at the time, Dr.
Nico pointed out that “newborn infections will greatly increase the risk of stroke in children, but they usually have more obvious symptoms.
” In order to confirm the diagnosis of stroke, the clinic team responded Daniel underwent a more extensive physical examination, including neuroimaging.
"Among children who have not died or experienced severe physical and mental disabilities, this is the most serious stroke I have ever seen.
" Daniel's MRI scan showed that a severe stroke during his infancy caused injuries to both sides of his brain.
There is a significant loss of tissue in areas of the brain related to thinking, emotion, memory, and advanced functions.
However, Daniel does not seem to have any cognitive, memory or emotional problems.
In the two brain hemispheres, there are also asymmetric injuries in the movement-related areas, which can affect skills such as movement and balance.
Usually, most strokes will damage one side of the brain, and the consequences of bilateral injuries will be more serious.
"Daniel's degree of injury may be on the edge of adapting to life.
" Dr.
Nico exclaimed. Amazing brain remodeling After confirming the diagnosis of stroke, Dr.
Nico, with the consent of Daniel and his family, carried out a series of motor and neurobehavioral tests and imaging studies on him.
Current neurobehavioral tests show that Daniel's score is generally within the normal range.
However, the motor skills assessment showed that Daniel's right upper limb was weaker in strength, speed and agility compared to the left upper limb.
Comparing Daniel's brain imaging data with the results of other young people, it is found that "part of Daniel's brain structure has disappeared, and he is missing almost a quarter of the cerebral cortex (cortex).
" ▲Daniel (left) and Dr.
Nico (Right) Brain image.
The dark area of Daniel’s brain image reflects the loss of a large number of tissues in the left and right hemispheres (picture source: Dosenbach lab).
The imaging examination also shows that in Daniel’s brain, the voids formed by the necrotic tissue are filled with cerebrospinal fluid, which can buffer and protect the brain from harm.
At the same time, it can also transport nutrients to the tissues and remove metabolic waste.
Neurons are also "connected" again, which promotes the maintenance of brain function.
Starting from the vicinity of healthy tissues, the "remaining" tissues after injury gradually restore interconnection.
Dr.
Nico said: "Our findings show that the brain is very tenacious in reorganizing and restoring functions.
Future research on the function of the lost tissue may provide more insights.
" American Heart Association data shows that every 4,000 newborns One will suffer a stroke.
"The health outcomes of these children vary.
About a quarter of lucky babies have healthy motor and cognitive functions.
" Dr.
Nico said, "In early childhood, the brain can continue, faster, and more completely.
In contrast, adult stroke can cause severe dysfunction and even death, which is difficult to recover.
But we are just beginning to understand the mechanism behind these phenomena.
"Normal life is the best arrangement for this special The case also shows that the prognosis of early stroke is difficult to predict accurately.
In the view of the medical team, “If Daniel is found to have a brain injury in his infancy, his family may be told that he will face severe developmental and cognitive delays.
He may not have the opportunity to go to school and participate in sports normally.
” Despite the right hand Not flexible enough, Daniel's life is normal.
He goes to school in the block, hangs out with friends, and plays baseball, football, and football from kindergarten to high school.
He has also obtained a university degree and is working on car repair technology.
"I didn't even know that he had a stroke.
" In retrospect, Kelly was shocked and grateful.
"Perhaps for him, a normal life is the best destiny arrangement.
" This is what Daniel thought.
"Every day, I have to think about it to operate smoothly with
my right hand.
But the last thing I want is that everyone treats me as a patient, and everything is fine.
" Title picture source: 123RF Reference [1] Timothy O Laumann, et al.
, (2021).
Brain network reorganisation in an adolescent after bilateral perinatal strokes.
The Lancet Neurology, DOI: https://doi.
org/10.
1016/S1474-4422(21)00062-4[2] Brain rewires itself after injury'on the edge of what's compatible with life'.
Retrieved March 24, 2021, from https://medicalxpress.
com/news/2021-03-brain-rewires-injury-edge-compatible.
html Note: This article aims to Introduce medical and health research progress, not a treatment plan recommendation. If you need guidance on treatment plans, please go to a regular hospital for treatment.
