June 19, 2012

"It's something you don't see every day, a patient who arrives awake and speaking with a 3-foot-spear in his head."

A 16-year-old boy survives a fishing accident.
When the teen arrived at the hospital...
The same hospital that houses Ronald Poppo, the man whose face was partially eaten off last month.
... medical staff used rebar cutters and vise grips from the Miami-Dade fire department to cut the shaft protruding from the boy's head so that they could fit him inside a CT scan machine....

It was a stroke of luck for [Yasser] Lopez that no one panicked and attempted to remove the spear before the teen got into surgery, since doing so could have damaged his brain, Bullock added.

"The amazing thing is that the boy is able to speak a little now," Bullock told reporters. "He's saying short sentences, he's out of bed, he's able to make his needs felt."

The teen has no memory of the accident and may never regain those memories, the doctor said.
Scary X-ray at the link.  It calls to mind the famous 19th century character Phineas Gage, who survived a iron rod blown through his head. Notably, Gage experienced a dramatic personality change:
"It's reported that he became what now would be classically described as 'disinhibited' - this is a classic term for what happens to some people after damage to their frontal lobes," says John Aggleton, professor of neuroscience at Cardiff University. "So, he loses his inhibitions, both in a social and emotional context.... Difficult company, to put it mildly."

For specialists, this was a staggering revelation. For the first time, this was evidence that damage to the brain could affect our behaviour and personality....

"It alerted people to the fact that a part of the brain - the frontal lobes - that we associate with sort of planning and intellectual strategies also had this important role in emotion," says Professor Aggleton. "That raised the question how on earth are emotion and intellect linked together?"
The path of the spear through Lopez's brain is different from the rod in Gage's. I'm not attempting to speculate about what effect this new injury might have. Best wishes to young Lopez.

19 comments:

Andy R. said...

In 4th grade, I got a fish hook in my eye. The white part. And I thought that was a good fishing injury story. A very talented eye surgeon managed to get the barbed hook out of my eye without leaving any permanent damage.

Jason said...

He had a heck of a time navigating the revolving door into the lobby.

traditionalguy said...

That is another amazing story with a Gabby Giffords like outcome. It is another victory for medical science that deserves our gratitude every day.

But thank God the kid was not still partially in a birth canal where another attitude can prevail.

Craig said...

Happy Juneteenth!

bagoh20 said...

Hey, lets all meet in Miami for a get together. Something awesome is sure to happen there. We could all sit at the same bar with our laptops and Ipads and blog about it. Then I could actually hit one of the commentators I throw my beer at many nights at home.

Just kidding - I wouldn't waste beer.

Petunia said...

That's amazing. Great job by the medical professionals.

NEVER remove an impaled object. Stabilize it in place and call 911 or get to the ER asap.

Andy, ouch! Glad you didn't have a permanent injury.

bagoh20 said...

"...without leaving any permanent damage."

Hahahaha. That's funny. He doesn't know, does he?

EDH said...

Michael Franti was unavailable for comment.

garage mahal said...

I've been to the ER 3-4 times for treble hooks stuck in me, I count myself lucky it was never anything more serious than that. I did take a gaff upside the temple real hard when a client tried free gaffing [and scooping] a Tripletail onto the boot. Luckily it wasn't the hook end.

JackOfClubs said...

The teen has no memory of the accident and may never regain those memories, the doctor said.

Good grief, who would want to?

edutcher said...

The quote sounds like a line out of a "Naked Gun" movie.

Or a Bugs Bunny cartoon.

traditionalguy said...

That is another amazing story with a Gabby Giffords like outcome.

According to The Blonde, Ms Giffords is most likely experiencing the same problems as Phineas Gage.

Craig said...

Happy Juneteenth!

By all means. This is when the Civil War really ended.

Thank you, Edward Canby.

PS I was going to reply to Hatman, but so many other have done so well.

Quaestor said...

Model showing a rod similar to the one which injured Gage. Notice that though slightly pointed the tamping rod is virtually blunt when compared to a spear, especially one fitted with a practice point instead of a barbed or trident point which is more typical. The rod which wounded Gage was much more destructive.

BarrySanders20 said...

"It's reported that he became what now would be classically described as 'disinhibited' - this is a classic term for what happens to some people after damage to their frontal lobes," says John Aggleton, professor of neuroscience at Cardiff University. "So, he loses his inhibitions, both in a social and emotional context.... Difficult company, to put it mildly."

So damage to the frontal lobe causes people to lose inhibitions and become "difficult company."

That disinhibited stuff seems to appear all over the comment sections of the intertubes. Maybe not a-holes after all, just disinhibited, perhaps from frontal lobe damage.

So before scolding, think about whether that nasty commenter really deserves your sympathy. Perhaps he got a spear or tamping rod blasted through his frontal lobe.

Michael K said...

We once had a kid about 16 come in with a sharpened paint roller handle through his head. He was part of a group of high school kids going to the beach at night in San Clemente. When they got to the beach, it was occupied by a Mexican gang. They turned around and left but this kid was by an open car window and one of the gangsters swung this sharpened pain roller handle and hit him. The straight part went right through his head. The handle part just hung there.

Talk about bizarre x-rays ! The kid survived but I don't know if he had permanent residuals.

Another time, a guy was grinding a piece of steel when the grinder grabbed it and spit it out at him. It was sticking out of his head. I think he was OK but needed a craniotomy.

The dumbest thing I ever did as a young surgery resident was with a guy who came in with a butcher knife sticking out of his neck. It was right in front and in to the handle. He looked at me and said, "I thought you were supposed to die when you did this." True story.

Like an idiot, I pulled out the knife and nothing happened. We watched him for a few hours and sent him to the ward. I should have taken him to the OR and removed it there. Fortunately, he and I were lucky. At least I was.

Michael K said...

"So damage to the frontal lobe causes people to lose inhibitions and become "difficult company."

I once resuscitated a woman who had had a cardiac arrest at home. This was before 911 and paramedics so she had been down a while when the ambulance arrived. She was young, 35, and it turned out she had a chronic heart condition, heart block. We got her going , we didn't know about the chronic block until she was defibrillated.

Anyway, she was comatose for a few days and we thought she was a goner. Then she woke up but had no memory of anything before she woke up in the hospital. It's a bizarre story. She knew language but did not, for example, know what tooth paste or makeup was. She also was a bit like a lobotomized patient. Her husband said he liked her better this way as she had always been kind of uptight.

She recovered and works at the hospital as a volunteer 30 years later.

David said...

If you can survive being named Yasser Lopez, you can survive anything.

And here's hoping he continues to survive this in good health.

Quaestor said...

She knew language but did not, for example, know what tooth paste or makeup was

Sounds like a case for Oliver Sacks.

Quaestor said...

If you can survive being named Yasser Lopez, you can survive anything.

Yasser as in Arafat? There a long-standing tradition among the Latins to give saints names to children which got co-opted by the Left over a century ago. Hence we have Benito Mussolini named after Juarez and Ilich Ramírez Sánchez, alias Carlos the Jackal, stupidly named after Lenin's patronymic, and others. I suppose there are plenty of little Adolfs running around Argentina and Paraguay .

Wally Kalbacken said...

This is how we do it in South Florida!