Sorry for the silly question, but does the brain cavity just fill up with
CSF after a hemispherectomy?  Is that mechanically stable?

I just saw an article in the paper about a little girl who had quite a bit
of her brain removed to control her seizures.  One of the hemispheres was
quite inflamed and she was continually seizing.

After reading the article, I thought, what do they do with that space?
Fill it with packing peanuts?

Well, I guess I won't be making it into med school soon. :-(

--

My name is Inigo Montoya, millionaire.  I own a mansion and a yacht.

It is my understanding that the technique used these days involves
removing just the cortex and perhaps other 'higher' structures, but
the mid-brain is left intact (I probably have my terms wrong).  So,
there is not as much space as you might think, and the fluid will fill
that in nicely.

--

                  Listen to CBC Radio on the Internet!
               WWW (Mosaic)/Gopher/FTP: debra.dgbt.doc.ca

It fills with CSF.  I suppose it is stable, since these patients don't
seem to get into trouble that way.

--
------------------------------------------------------------------------------
Gordon Banks  N3JXP      |"I can eat more fat meat than you can cook in a week

------------------------------------------------------------------------------

Cerebrospinal fluid (CSF) accounts for a significant amount of the normal
intracranial volume (about 500 ml or a half quart).  In a sense the brain
"floats" in this CSF.  I Have assisted, as a medical student, in several
intracranial surgeries (several aneurysm clippings and one tumor
resection), and in the surgeries I saw, after opening the skull and dura,
the CSF was "sucked out" to keep the operative field clear.  As this
happened, the brain seemed to collapse, leaving a lot of empty space
between the brain and the dura (even without removing brain tissue).  When
the dura was closed, the space filled backed in, presumably with new CSF.  

Is it mechanically stable?  Probably as stable as anybodyelse's brain.
Since the brain normally (ie. in everyone) floats in the 500 ml of CSF, it
more than likely is stable when there is 800 ml of CSF, or whatever it
would be when half the cerbral cortex is removed.

Just my $0.02

Nick Waanders