Fact Check: Medical Images Show Man with 90% of His Brain 'Missing'?

Claim:

Medical images published in 2007 document a 44-year-old man who was “missing 90% of his brain.”

Rating:

Mixture ( About this rating? )

What's True:

The images are authentic and genuinely show the brain of a 44-year-old man with an excess amount of fluid in parts of his brain that may have possibly displaced other brain matter. The images were first published in the medical journal The Lancet in 2007.

What's False:

It does not appear that this excess fluid caused 90% of the man’s brain to go “missing,” as some posts on social media suggest.

What's Undetermined:

It's unknown the full extent of how the hydrocephalus impacted this man's brain, including how many neurons may have been destroyed, or how much brain matter was compressed or displaced.

"You don't need most of your brain to lead a normal life," is a sentiment that often accompanies a widely shared set of medical images that allegedly show a 44-year-old man who was "missing 90% of his brain."

Since 2007, the images have been posted to social media platforms like Reddit , Facebook , YouTube and TikTok , including the below Reddit post, which had received more than 46,000 upvotes as of this publication.

TIL of a man who was discovered to be unknowingly missing 90% of his brain, and was living a normal life.
by u/GodIsAnAnimeGirl in todayilearned

The images are authentic and genuinely show the brain of a 44-year-old man with an excess amount of fluid in parts of his brain that may have possibly displaced other brain matter. They were first published in the medical journal, The Lancet, in 2007.

However, it's unknown whether this excess fluid caused 90% of the man's brain to go "missing," as some posts on social media suggest.

Snopes reached out to several neuroscientists and researchers for assistance with interpreting the images and we will update this article when a response is received.

In the meantime, we've rated this claim as a "Mixture" of truth/falsehood.

The images were first published in a July 21, 2007, issue of The Lancet in an article titled " Brain of a white-collar worker ."

The case report describes the brain of a 44-year-old married civil servant and father of two who went to doctors after two weeks of experiencing mild weakness in his left leg. Brain scans showed severe dilation of the lateral ventricles , two c-shaped regions in the brain, one of which is found in each hemisphere. The dilation had caused the fluid-filled areas to become larger than normal .

When he was just 6 months old, he was diagnosed with hydrocephalus , a condition associated with the buildup of excess fluid in the brain. Its cause was unknown. He was given a ventriculoatrial shunt, which is described by Johns Hopkins Medicine as a device used to drain and redirect cerebrospinal fluid.

At 14, he developed ataxia, a neurological condition related to poor muscle control leg weakness. His symptoms were resolved after doctors "revised" the shunt.

Though his IQ was below average, the man reportedly had a history of otherwise normal neurological development

He was diagnosed with non-communicating hydrocephalus , an obstruction of the cerebral spinal fluid flow in the brain. Doctors performed a ventriculocisternostomy , a procedure that allows for excess fluid to drain out of the brain. His Leg weakness eventually improved over time.

The original case report published in The Lancet reads:

A 44-year-old man presented with a 2-week history of mild left leg weakness. At the age of 6 months, he had undergone a ventriculoatrial shunt, because of postnatal hydrocephalus of unknown cause. When he was 14 years old, he developed ataxia and paresis of the left leg, which resolved entirely after shunt revision. His neurological development and medical history were otherwise normal. He was a married father of two children, and worked as a civil servant. On neuropsychological testing, he proved to have an intelligence quotient (IQ) of 75: his verbal IQ was 84, and his performance IQ 70. CT showed severe dilatation of the lateral ventricles (figure); MRI revealed massive enlargement of the lateral, third, and fourth ventricles, a very thin cortical mantle and a posterior fossa cyst. We diagnosed a non-communicating hydrocephalus, with probable stenosis of Magendie's foramen (figure). The leg weakness improved partly after neuroendoscopic ventriculocisternostomy, but soon recurred; however, after a ventriculoperitoneal shunt was inserted, the findings on neurological examination became normal within a few weeks. The findings on neuropsychological testing and CT did not change.

Claims that the man was "missing" 90% of his brain appear to have originated with news publications covering the work of Axel Cleeremens , a cognitive psychologist who reportedly lectured about the case during the 2016 session of the Association for the Scientific Study of Consciousness conference in Buenos Aires.

As some publications reported , "the majority of the man's brain was slowly destroyed over the course of 30 years by the build-up of fluid in the brain, a condition known as hydrocephalus." However, as is shown in the case report text above, there is no mention of any part of the brain being "missing."

Cleeremans confirmed to Snopes via email that it is not true to say this person is missing 90% of his brain, but "nobody knows exactly how many neurons have been destroyed by hydrocephalus." He wrote:

This condition, in which the cerebrospinal fluid that fills the ventricles of the brain normally fails to properly evacuate and thus accumulates, is known to destroy the cell bodies of neurons as well as the white matter, that is the connections between neurons.

But most of the neurons in this patient's brain are probably compressed into the very fine residual layer.

So the patient has lost many neurons, and those neurons that are left are compressed against the skull.

Cleeremans added that the images do not show other parts of the brain that should be visible, including the hippocampus and thalamus. From his perspective, the case " illustrates the striking resilience of the brain and its capacity to adapt and rewire itself in the face of this progressive loss of neurons and neuronal connections."

Finally, Cleeremans said that the media at the time oversimplified the story to suggest that a person can function properly with only 10% of their brain.

In a 2015 interview with Quartz , Cleeremans discussed the concept of consciousness and how a person may learn it over time, rather than being born with it, and used the Frenchman's story as an example. Cleeremans published his theory in 2011 in the peer-reviewed journal, Frontiers in Psychology .

Sources:

- YouTube. https://www.youtube.com/watch?v=0CpxdMYwbiY . Accessed 2 Sept. 2024.

10K Views · 137 Reactions | The Man Who Lost 90% of His Brain But Lived a Normal Life | Imagine Going to the Doctor for a Slight Pain in Your Leg and Finding out You've Got No Brain Matter to Speak of. | By Sunday RoastFacebook. www.facebook.com, https://www.facebook.com/sunday.roast.media/videos/the-man-who-lost-90-of-his-brain-but-lived-a-normal-life/381929278077994/ . Accessed 2 Sept. 2024.

A Man Who Lives without 90% of His Brain Is Challenging Our Concept of "consciousness" - Business Insider. 16 July 2016, https://web.archive.org/web/20160716231815/https://www.businessinsider.com/missing-90-percent-of-brain-neuroscience-2016-7 .

---. 16 July 2016, https://web.archive.org/web/20160716231815/https://www.businessinsider.com/missing-90-percent-of-brain-neuroscience-2016-7 .

Cleeremans, Axel. "The Radical Plasticity Thesis: How the Brain Learns to Be Conscious." Frontiers in Psychology, vol. 2, May 2011, p. 86. PubMed Central, https://doi.org/10.3389/fpsyg.2011.00086 .

Goldhill, Olivia. "A Civil Servant Missing Most of His Brain Challenges Our Most Basic Theories of Consciousness." Quartz, 2 July 2016, https://qz.com/722614/a-civil-servant-missing-most-of-his-brain-challenges-our-most-basic-theories-of-consciousness .

Hydrocephalus in Infants and Children: Diagnosis & Treatment. 3 Feb. 2023, https://www.hydroassoc.org/hydrocephalus-in-infants-and-children/ .

Lateral Ventricle - an Overview | ScienceDirect Topics. https://www.sciencedirect.com/topics/neuroscience/lateral-ventricle . Accessed 2 Sept. 2024.

MacDonald, Fiona. "Meet The Man Who Lives Normally With Damage to 90% of His Brain." ScienceAlert, 13 July 2016, https://www.sciencealert.com/a-man-who-lives-without-90-of-his-brain-is-challenging-our-understanding-of-consciousness .

Maller, Vijetha V., and Richard Ian Gray. "Noncommunicating Hydrocephalus." Seminars in Ultrasound, CT and MRI, vol. 37, no. 2, Apr. 2016, pp. 109–19. ScienceDirect, https://doi.org/10.1053/j.sult.2015.12.004 .

"Scientists Research Man Missing 90% of His Brain Who Leads a Normal Life." CBC Radio, 14 July 2016. CBC.ca, https://www.cbc.ca/radio/asithappens/as-it-happens-thursday-edition-1.3679117/scientists-research-man-missing-90-of-his-brain-who-leads-a-normal-life-1.3679125 .

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TikTok - Make Your Day. https://www.tiktok.com/@idcsterling/video/7373799840536366382 . Accessed 2 Sept. 2024.

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Ventriculocisternostomy - an Overview | ScienceDirect Topics. https://www.sciencedirect.com/topics/medicine-and-dentistry/ventriculocisternostomy . Accessed 2 Sept. 2024.

"Ventriculomegaly." UCSF BCH Fetal Treatment Center - Ventriculomegaly, https://fetus.ucsf.edu/ventriculomegaly/ . Accessed 2 Sept. 2024.

Wong, Timothy, et al. "Ventriculopleural Shunt: Review of Literature and Novel Ways to Improve Ventriculopleural Shunt Tolerance." Journal of the Neurological Sciences, vol. 428, Sept. 2021, p. 117564. ScienceDirect, https://doi.org/10.1016/j.jns.2021.117564.