Plasticity of the central nervous system: a neurosurgeon's experience of cerebral compensation and decompensation

Cerebral plasticity constitutes one of the most decisive factors in recovery and readaptation after cerebral lesions. In contrast to the considerable progress in current studies on normal neuronal plasticity including the idea of "l'homme neuronal", the concept of plasticity postulate...

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Bibliographic Details
Published in:Acta neurochirurgica 1985-01, Vol.77 (3-4), p.81-102
Main Author: PIA, H. W
Format: Article
Language:English
Subjects:
Adaptation, Physiological
Adolescent
Adult
Age Factors
Aged
Biological and medical sciences
Biological Evolution
Brain - physiopathology
Brain - surgery
Brain Diseases - physiopathology
Brain Diseases - rehabilitation
Brain Diseases - surgery
Female
Humans
Male
Medical sciences
Middle Aged
Neuronal Plasticity
Neurosurgery
Philosophy
Skull - physiopathology
Skull, brain, vascular surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
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Summary:Cerebral plasticity constitutes one of the most decisive factors in recovery and readaptation after cerebral lesions. In contrast to the considerable progress in current studies on normal neuronal plasticity including the idea of "l'homme neuronal", the concept of plasticity postulated by Albrecht Bethe in 1929 received little attention. The author, as a neurosurgeon, has tried to describe cranial morphological plasticity, morphological and functional plasticity in infantile encephalopathies and especially in hemiatrophic lesions. It is supposed that a true morphological substrate exists due to compensatory hyperplasia of the uninvolved hemisphere. Modern neurosurgical techniques have demonstrated that the functional plastic capacity is much larger than has been supposed, even in the elderly. Some aspects of the mechanisms of compensation and decompensation of cortical and subcortical structures as well as of the central regulation systems are discussed. The full extent of the amazing recovery and functional reorganization is reached by plastic capacity, personal motivation, adequate training and sufficient time. The contribution ends with an exposition of a personal philosophy concerning psycho-somatic dualism, the body-mind problem, the future of the human brain and the ethical outlook, based on the progressive biological evolution of the basal neocortex and the immanent functional development (H. Spatz).
ISSN:0001-6268
0942-0940
DOI:10.1007/BF01476213