Brain questions – help appreciated

[Guest savage taste]

Years ago, a med student told me about a patient that arrived in the ER with a severe head injury. The attending intern touched the patient’s brain in a way that killed the patient. According to the teller of the tale, it was a mistake that was completely unnecessary had the brain been handled properly. No one present reported the death as a mistake—the patient was listed as DOA.

 

This story is now ancient, and I recall only the broad points above. I’d like to use the anecdote in a piece of fiction. Can anyone help me with the following questions?

 

What part of the brain would likely cause instant death if touched?

 

Is there any part of the brain in which palpation would not cause injury?

 

Any comments or answers are appreciated.

[Glider]

The brain is very delicate. However, as long as the inner meninges are intact (duramater and piamater), you can touch the brain (gently) without doing any damage. Neurosurgeons do it all the time. However, if you were to poke your finger into it and wiggle it about, you are likely to do some damage.

 

The regions of the brain responsible for life processes are low down, below the cortex; mid-brain/hind-brain and brain stem. If they were exposed during trauma, the person would be dead anyway.

 

What part of the brain would likely cause instant death if touched?

The brainstem perhaps. Even then, it would have to be poked quite hard.

 

Is there any part of the brain in which palpation would not cause injury?

Most of it. As I say, surgeons touch the cortex all the time without doing any damage. They lay grids of microelectrodes on the surface of the cortex to gain high-resolution direct EEG when searching for generator loci in epileptic patients. However, the cortex is really the only structure you can access.

 

Any comments or answers are appreciated.

There is a way that touching the cortex can kill. If you press gently down, although you won't damage the cortex, you will cause 'coning'. This happens when people get an intracranial bleed. The increased intracranial pressure, although causing no direct damage to the brain, forces the brain downwards, this causes the brainstem to be forced into the foramen magnum (the hole in the base of your skull that the spinal cord passes through). This is known as coning. The pressure on the brainstem, which contains structures necessary for life processes; the pons and medulla oblongata, will kill a person very quickly.