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  #1  
Old 07-13-2012, 07:10 AM
Drygon Drygon is offline
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What happens to dead brain tissue after a stroke?

Quick back story: Back in February I had a dissection in my vertebral artery which lead to a cerebellar stroke. The doctors didn't realize it was a stroke until 2 or 3 days later, so I didn't really have much intervention and they said that basically the left half of my cerebellum is dead.

A question I asked the doctors and never got a clear response is, what happens to all the dead brain tissue? Does it just shrivel up and hang out for the rest of my life? Does it get broken down and I have a void in my skull? The still-living parts of my brain want to know!

I've tried googling, but my google-fu is weak on this one. All I get are sites talking about how the brain can regenerate somewhat after a stroke (which I don't understand, I thought once a brain cell was dead, it was dead).
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  #2  
Old 07-13-2012, 07:27 AM
Der Trihs Der Trihs is offline
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I don't know about your main question, but:

Quote:
Originally Posted by Drygon View Post
All I get are sites talking about how the brain can regenerate somewhat after a stroke (which I don't understand, I thought once a brain cell was dead, it was dead).
That's more a matter of the brain rewiring itself around the damage.
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Old 07-13-2012, 07:44 AM
Mijin Mijin is online now
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Quote:
Originally Posted by Drygon View Post
A question I asked the doctors and never got a clear response is, what happens to all the dead brain tissue? Does it just shrivel up and hang out for the rest of my life? Does it get broken down and I have a void in my skull?
Sort of both. On MRI scans it's possible to tell how long ago an infarction may have occurred by the stages of healing / scarring.
Long term you end up with "scar tissue", and that tissue takes up less volume, so adjacent areas might expand slightly.

Quote:
Originally Posted by Der Trihs
That's more a matter of the brain rewiring itself around the damage.
Not necessarily; in most strokes some tissue is damaged only temporarily/incompletely due to hypoxia. There is often an "umbra" in which tissue damage is irreversible and a "penumbra" in which there is compromised function that may return in time.

ETA: IANA doctor, I just have a neuroscience master's

Last edited by Mijin; 07-13-2012 at 07:48 AM..
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Old 07-13-2012, 07:50 AM
Earl Snake-Hips Tucker Earl Snake-Hips Tucker is online now
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Quote:
Originally Posted by Der Trihs View Post
I don't know about your main question, but:

That's more a matter of the brain rewiring itself around the damage.
To add to this, in one documentary I saw, a neurologist was talking about the brain "healing" after a TBI (traumatic brain injury). He said that in our minds we think of the brain healing like a wound, but in actuality, it's closer to look at it this way: After a TBI, you have a different brain from the one you had previously. The "healing" process is actually getting the new brain to start relearning the functions that the old brain did.
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  #5  
Old 07-13-2012, 08:23 AM
orcenio orcenio is online now
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Not a doctor just another person with a MSc in Neuroscience.

In the Central Nervous System (CNS) dead neuronal tissue would be broken down by a specialized Glial cell called Microglia; whose job is to circulate the CNS and swallow up/destroy odd bits of foreign/non-functional matter. The "empty space" left by those deconstructed cells would be replaced by other various glial cells (probably astrocytes through scarring).

Fun fact: glial cells make up ~90% of our brain, and work to support the function of our neurons.
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Old 07-13-2012, 10:12 AM
John DiFool John DiFool is online now
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Half the cerebellum? I guess my mom (who had one this spring) got off lucky.
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  #7  
Old 07-13-2012, 10:37 AM
needscoffee needscoffee is offline
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We were told by a leading neurologist from Albert Einstein College of Medicine last year that the newest school of thought believes that there is some new cell growth in brains (after trauma or not?), but how much and to what extent it is useful is still unknown. He stressed that doctors used to believe we never made any more brain cells beyond the ones we are born with and that this is irrefutably not the case.
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Old 07-13-2012, 02:17 PM
ArmenE ArmenE is offline
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Originally Posted by orcenio View Post
Fun fact: glial cells make up ~90% of our brain, and work to support the function of our neurons.
This is not true. No citations for such a fact exist and recent attempts to count put us at 1:1 neurons:glia
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Old 07-13-2012, 10:18 PM
orcenio orcenio is online now
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This is not true. No citations for such a fact exist and recent attempts to count put us at 1:1 neurons:glia
The real funny thing is that I've both read AND quoted that paper on the straightdope before.

Last edited by orcenio; 07-13-2012 at 10:18 PM..
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Old 07-13-2012, 11:42 PM
Ele the Stoic Ele the Stoic is offline
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Quote:
Originally Posted by needscoffee View Post
We were told by a leading neurologist from Albert Einstein College of Medicine last year that the newest school of thought believes that there is some new cell growth in brains (after trauma or not?), but how much and to what extent it is useful is still unknown. He stressed that doctors used to believe we never made any more brain cells beyond the ones we are born with and that this is irrefutably not the case.
I've heard this too. Supposedly our brain does indeed have stem cells available to reconstruct a certain amount of damage, in addition to the rewiring. From what I understand, it's also a factor of time, not age - that is to say, if you're 50 and live to be 100, you'll heal as much as a 20 year old who lives to be 70. Read it in some medical journal, not sure which one, it was a while ago, so I don't have a cite. But if it's requested, I can try looking for it again.
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  #11  
Old 07-14-2012, 03:47 AM
benbo1 benbo1 is offline
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From a previous Cecil column (too lazy to cite now) - we have extra brain cells that have just been sitting there doing nothing. When needed, like after a stroke, they can be pressed into service to relearn to walk, talk, juggle, etc. The proof is that some people recover completely from strokes; this wouldn't be possible if every cell had to be accounted for. The column topic was something like 'what do they mean when they say we only use 10% of our brains?'. The thrust of the answer was that we simply got extra cells that in ordinary circumstances would never be used.
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Old 07-14-2012, 04:36 AM
Mijin Mijin is online now
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Quote:
Originally Posted by benbo1 View Post
From a previous Cecil column (too lazy to cite now) - we have extra brain cells that have just been sitting there doing nothing. When needed, like after a stroke, they can be pressed into service to relearn to walk, talk, juggle, etc. The proof is that some people recover completely from strokes; this wouldn't be possible if every cell had to be accounted for.
Yeah but as I said before, after a stroke a lot of tissue may only have temporarily impaired function anyway. Paralysis down much of one side of the body, then recovering much of the original movement within weeks, is fairly common.
If it were a matter of rewiring, neurogenesis or forming new connections, it would not happen this fast.

Quote:
The column topic was something like 'what do they mean when they say we only use 10% of our brains?'. The thrust of the answer was that we simply got extra cells that in ordinary circumstances would never be used.
Possibly true but of course it would not be anything like 90% of cells being surplus.

Last edited by Mijin; 07-14-2012 at 04:36 AM..
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  #13  
Old 07-14-2012, 07:00 AM
Digital is the new Analog Digital is the new Analog is online now
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Quote:
Originally Posted by benbo1 View Post
From a previous Cecil column (too lazy to cite now) - we have extra brain cells that have just been sitting there doing nothing. When needed, like after a stroke, they can be pressed into service to relearn to walk, talk, juggle, etc. The proof is that some people recover completely from strokes; this wouldn't be possible if every cell had to be accounted for. The column topic was something like 'what do they mean when they say we only use 10% of our brains?'. The thrust of the answer was that we simply got extra cells that in ordinary circumstances would never be used.
Do we really use only 10 percent of our brains

Thread from Comments on Cecil's Columns/Staff Reports


-D/a
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  #14  
Old 07-14-2012, 11:00 AM
RaftPeople RaftPeople is offline
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Quote:
Originally Posted by Ele the Stoic View Post
I've heard this too. Supposedly our brain does indeed have stem cells available to reconstruct a certain amount of damage, in addition to the rewiring. From what I understand, it's also a factor of time, not age - that is to say, if you're 50 and live to be 100, you'll heal as much as a 20 year old who lives to be 70. Read it in some medical journal, not sure which one, it was a while ago, so I don't have a cite. But if it's requested, I can try looking for it again.
I read about this earlier this year, here's a blurb:
"Researchers at Lund University in Sweden have discovered a new stem cell in the adult brain. These cells can proliferate and form several different cell types—most importantly, they can form new brain cells."
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  #15  
Old 07-14-2012, 06:31 PM
Jackmannii Jackmannii is offline
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Brain tissue after infarction does not undergo scarring as in organs like the heart.

Instead, it commonly breaks down, liquifies while macrophages remove debris and ultimately a cavity is left behind. More on liquefactive necrosis here.

Of course it's an entirely separate issue as to what rewiring can be accomplished so that functions can be performed without the affected tissue.

How are you making out, Drygon?
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