Long-term Effects of Bilateral Frontal Brain Lesion: 60 Years After Injury With an Iron Bar
Abstract
Background Harlow's report of the case of Phineas P. Gage in 1848 was one of the earliest description of the personality and behavioral changes following frontal lobe damage. Since Harlow's articles, a few more case reports of frontal lobe damage have been published. As standard neuropsychological and neurologic evaluations may reveal subtle defects, case reports have been particularly useful in characterizing the behavioral changes that follow frontal lobe damage. Objective To describe the long-term outcome of an 81-year-old patient who sustained a severe frontal brain lesion 60 years ago caused by the passage of an iron spike through his head. Results The patient has bilateral damage affecting the orbital and dorsolateral frontal regions. He displays many of the typical frontal behavioral disturbances described in the literature. His conduct is characterized by dependence on others, cheerfulness, planning difficulties, problems establishing realistic goals, lack of drive, and difficulties in initiating, continuing, and finishing activities. Although gross cognitive functioning is intact, neuropsychological deficits are present in the executive functioning, memory, and visuoconstructive domains. Conclusions In contrast with the antisocial conduct pattern usually associated with frontal damage in the literature, this case suggests that large frontal lesions can produce behavioral and personality changes that are compatible with stable functioning in family, professional, and…
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A patient with frontal lobe injury from an iron spike had difficulty planning, became more irritable, and had problems regulating emotions.
“For example, Mataró, Jurado, García-Sánchez et al. [2001] describe the behavior of a Spanish patient whose head was impaled by an iron spike, injuring both frontal lobes.Like Phineas Gage, his behavior changed.After the accident, he had difficulty planning, became more irritable, and had problems regulating emotions.”
From Personality Psychology and Economics (2011) · cites this paper as Mataró, Jurado, García-Sánchez et al. [2001]
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- Authors
- Mataró, M., Jurado, M. Á., García-Sánchez, C., Barraquer, L., Costa-Jussà, F. R., & Junqué, C.
- ORCID
- Junqué, Carme
- Venue
- Archives of Neurology
- Publisher
- American Medical Association (AMA)
- Published
- 2001-07-01
- Volume
- 58
- Issue
- 7
- Pages
- 1139
- ISSN
- 0003-9942 (ISSN-L)
- OpenAlex
- W2029638188
- Cited by
- 54
- References
- 9
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 1 · 2023: 1 · 2021: 2 · 2020: 1 · 2019: 2 · 2018: 2 · 2017: 4 · 2016: 1 · 2015: 6 · 2014: 1 · 2013: 3 · 2012: 5
- FWCI
- 0.75
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Neurology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Social Sciences › Psychology › Clinical Psychology › Historical and Modern Theater Studies
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- frontal lobe damage, long-term outcomes, personality change, executive dysfunction, memory impairment, antisocial behavior, Phineas Gage, elderly patients
- MeSH terms
- Adult, Affect, Aged, Brain Injuries, Cognition Disorders, Frontal Lobe, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Neuropsychological Tests, Personality, Wechsler Scales, Head Injuries, Penetrating
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