Sunday, August 19, 2012

A 21st Century Phineas Gage

Is it wrong that I feel a little rill of excitement traveling down my spine when something like this happens? That I have some morbid curiosity to find out exactly how this young man's terrible misfortune will translate into interesting scientific findings? We have prohibited ourselves from conducting so-called impossible experiments, such as willingly depriving children of any social contact to see the effects on their development, or subjecting someone to a marathon of Jersey Shore reruns, because these would be monstrous and unethical things to do; however, whenever someone has a stroke or injury which destroys part of their brain, we can't help but feel an odd mixture of sympathy for their plight, and the giddy sensation that we have hit a case study jackpot.

The story: A Brazilian construction worker named Eduardo was minding his own business, constructing stuff and whistling at those ripe Brazilian hunnies walking past his construction site, when he was struck by a falling metal rod which impaled the top of his head and partially exited between his eyes.

CT scan showing the metal rod in Eduardo's skull.
Eduardo, being a total boss, remained calm and was able to explain the situation to the doctors. Seeing their shocked expressions, he was even able to joke, "What, do I have something on my face?"

After a five-hour-long surgery, the rod was extracted, and Eduardo did not appear to show any signs of distress, pain, or malfunctioning. The head neurosurgeon also had this to say:

[The head neurosurgeon] said the bar entered a "non-eloquent" area of the brain that doesn't have a specific, major known function. [Eduardo] Leite is expected to remain in hospital for at least two weeks.

I'm not sure what "non-eloquent" means, exactly, but the fact is, that piece of metal took out a large chunk of real estate, and there actually are some specific, major known functions for that part of the brain that just got obliterated. The reason this case is so intriguing is because it closely mirrors an accident which occurred over a century and a half ago: The famous case of Phineas Gage.

Like Eduardo, Phineas was minding his own business, constructing railroads and shouting at those white breezeys, when a small explosion sent a tamping iron through the bottom of his skull and out the top of his head.

Reconstruction of the tamping iron's path through Gage's skull. Given the time period, scientists hypothesize that Phineas' first words were, "Egad!"
The injury blew out most of Gage's left inferior frontal lobe, and observers noted several dramatic changes in his behavior following the incident: He had become more irritable, more impulsive, and appeared unable to manage his day-to-day life as he had done before, supposedly due to an impaired ability to properly evaluate the consequences of his actions. Given this, neuroscientist Antonio Damasio hypothesized that the frontal lobes were necessary for interpreting and regulating emotional states, and for responding to more abstract aspects of decision-making (e.g., the amount of money one would be willing to pay for a given option; Croxson et al, 2009).

In any case, an MRI will be needed to determine the location and extent of the damage, and I am sure that Eduardo will be undergoing a battery of tests to examine any changes in his cognitive or emotional capacities; it will be interesting to see if this adds anything new to what the current lesion studies and non-invasive procedures have revealed about this region (or, more likely, regions). I also propose that, since he has taken one for the team, so to speak, Eduardo should be well-compensated by the scientific community; fifteen dollars an hour for his study participation, perhaps; a swimming pool filled with Nutella; and a harem of the world's finest chicas. It is only right that we give something back to those who have suffered the vicissitudes of fate and have given us something in the bargain.

Link: Iron Bar Removed from Builder's Head

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