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Frontal lobe metastases cause Phinaes Gage syndrome

Posted Aug 24 2008 11:31pm
I got this email from my esteemed colleague and friend, Dr. Gerald Colvin:



"Hi Brian,

Here is an addition to your blog from your esteemed colleague and friend. This patient has metastatic non-small cell lung carcinoma and presented to us with mental status changes. He was found to have bilateral frontal lobe tumors causing significant edema. What is interesting about this case was that he has personality changes reminded me of those of Phineas P. Gage was reported to have. Gage's remains I believe are housed in Boston. I did see something on display in a London museum when I was there a million years ago

Ger-"



Most of us know the story of the railroad construction foreman Phineas Gage, who, in 1848, suffered an accident on the job which resulted in a 13-pound iron rod shooting through the front of his brain. Gage survived the accident, and lived 11 years more. But he was never the same. His physician, Dr. Harlow, describes Phineas some time after the accident as “fitful, irreverent, indulging at times in the grossest profanity (which was not previously his custom), manifesting but little deference for his fellows, impatient of restraint or advice when it conflicts with his desires.” (Reference: Phineas Gage: A Gruesome But True Story About Brain Science by John Fleischman, HMCo Children’s Books, 2004).
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