Neuropsychological Functioning After Traumatic Injury to The Orbito-Frontal Area: A Polish Phineas Gage

Abstract

The patient (PG, age 27, owner/operator of a construction company) suffered a severe head injury after a fall from scaffolding at a construction site. Two wooden pegs were broken off and driven deep-into his cranium, from left to right. However, the patient not only survived the injury, he did not even lose consciousness after the accident. The damage to the brain affected primarily the frontal lobes. The upper peg penetrated the right frontal lobe. In the years that followed neurosurgery, we observed a pattern of behavioral disorders consistent with frontal lobe syndrome, similar to the famous 19th-century case of Phineas Gage. These symptoms make it impossible for the patient to adapt to social and cultural life. The purpose of our research was to describe the profile of negative and positive behavioral disturbances in PG, and to determine whether these behaviors developed over time into orbitofrontal syndrome. Microgenetic theory is used to interpret the formation of the symptom.