There’s an old story about a man who took a railroad spike through the head and survived, but developed an entirely new personality afterwards. The story is true; the man’s name was Phineas Gage, (he has his own Wikipedia page) and while blowing up rock to build railroad tracks, he accidentally lined his head up with a blast hole. A tamping iron shot up in the blast and skewered Mr. Gage’s head, destroying his left frontal lobe. After he recovered from his injuries, Mr. Gage’s personality changed entirely – though, wonder of wonders, he maintained most of his memories and intelligence.

What happened to Mr. Gage isn’t uncommon, though it may be extreme: changes in personality can and do occur in traumatic brain injury (TBI) patients. According to the Centers for Disease Control and Prevention (CDC), a severe TBI “may lead to a wide range of short- or long-term issues affecting:

  • Cognitive Function (attention and memory)
  • Motor function (extremity weakness, impaired coordination and balance)
  • Sensation (hearing, vision, impaired perception and touch)
  • Behavior (emotional regulation, depression, anxiety, aggression, impairments in behavioral control, personality changes)”

The CDC also lists amnesia as a possible outcome of a TBI.

TBIs have ripple effects

In the case of Mr. Gage, physical damage to his frontal lobe seems to be the cause of the changes to his personality, but a TBI can have a ripple effect; it is possible that some types of brain damage or injury don’t actually affect personality at all, but that the personality changes are a byproduct of the injury.

Let us explain.

Imagine you woke up tomorrow with a brain injury that affects the left side of your body and your ability to recall words easily, much like a stroke would do. You find that it’s harder to walk, harder to button up your own shirt, even harder to cut your dinner with a knife. On top of that, you’re struggling to remember the right words, so you can’t ask for help, or call out to your wife or kids.

Sounds frustrating, right? Maybe it makes you a little “cranky” or irritable, or maybe it makes you feel anxious. Maybe the frustration leads to your crying a little more often, or yelling more. Suddenly, the TBI has caused a change in your personality – or, at least, so everyone keeps whispering when they think you’re out of ear shot.

This is what we mean by “ripple” effects. In this scenario, the change in your behaviors is brought on by other effects of your brain injury, and the knowledge that this might just be the rest of your life. So while there are folks out there whose brains are damaged in ways where their personalities are, indeed, changed forever, a lot of TBI victims are simply unable to express what they need in a way that makes sense to their loved ones and caretakers.

It’s not always severe TBI that causes these changes

Take the same scenario, but spread out the changes: instead of immediately losing your words, it happens gradually over weeks. Instead of being unable to use your left side upon waking, you seem to be a bit worse every day.

When you have a concussion, or “mild” traumatic brain injury (mTBI), doctors can easily miss something on the initial scan of your brain. And if you or your loved one “feels fine” after a car accident, or after a fall, you may feel tempted to skip that next doctor’s appointment. Or, you may not realize that your condition is getting worse, so you don’t mention the random headache, or the lost word; after all, you don’t want to be a bother to anyone, right?

The truth is, something like a third of all mTBIs go undiagnosed after an accident, and not all injury victims get the appropriate or adequate care that they need as a result. So if you have a concussion, it is just as important to get the right scans as tests as it is if you suffer a severe TBI, like Mr. Gage did. The effects can be just as serious over time, and just as permanent.

At Mezrano Law Firm, we take a special interest in helping people who have sustained some levels of brain injury as a result of another person’s negligence. We make sure that you get the help you need, when you need it – and that your family, friends, and caretakers get help, too. If you have been hurt, we are here to help. To schedule a free consultation with one of our Alabama brain injury lawyers, please call 205-206-6300 or fill out this contact form. We have offices throughout the state, including in Birmingham, Florence, Gadsden, Mobile, Montgomery, and Tuscaloosa.