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Brain imaging revealed a significant accumulation of fluid in a man’s brain that had compressed its tissues against the skull.(Image credit: Getty Images)
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The patient: A 44-year-old individual from France
The symptoms: For a fortnight leading up to his medical consultation, the man experienced mild weakness in his left leg. He had no significant medical history or developmental anomalies, apart from a necessity for a shunt to be fitted in his head at six months old. The shunt addressed fluid buildup in his brain of unknown origin. This shunt was removed when he reached the age of 14.
Subsequent events: Upon reporting his leg weakness to healthcare professionals, the man underwent CT and MRI scans of his head. Neuropsychological assessments were also conducted, indicating an IQ of 75, which falls below the average score of 100.
The diagnosis: Medical experts concluded that the patient possessed a brain that was less than half the typical size.
The brain scans additionally showed a substantial accumulation of fluid within his brain, leaving minimal space for tissue. This resulted in the patient having merely a thin layer of brain tissue pressed against his skull. The scans depicted highly enlarged fluid-filled spaces in the brain, known as ventricles. It is probable that this fluid accumulation contributed to the man’s leg weakness.
The treatment: Medical practitioners relieved the man’s skull of this excess fluid, which aided in restoring some of his leg strength. According to a case report detailed in The Lancet, a new shunt was also implanted within the man’s skull. Within several weeks, the patient’s neurological evaluations, used to assess his leg weakness, returned to their previous state. “The outcomes of neuropsychological testing and CT scans remained unchanged,” the report stated, implying his IQ did not alter significantly.
What makes the case unique: Throughout human evolutionary history, our brains have become considerably larger compared to those of our closest relatives, fostering enhanced cognitive abilities and language skills. The precise factors behind this growth are not entirely clear but are likely attributed to a blend of environmental influences, dietary considerations, and other evolutionary pressures.
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A human brain also undergoes considerable expansion during an individual’s lifespan, with the adult brain generally being substantially larger than a newborn’s brain. In this man’s instance, one might have anticipated cognitive impairments due to his brain being smaller than average. However, despite his reduced brain size, the man exhibited no impairments and was employed as a civil servant.
If he had not experienced leg weakness, his unusually small brain might have remained undetected.
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This article was originally published on February 19, 2025.
