A scientific foil to your accidental brain injury

Inkling Magazine has a fantastic article detailing unusual objects which have accidentally ended up in the brain and have subsequently made the pages of medical journals as surprising case reports.

It covers everything from fairly lights to stiletto heels to human teeth and is cheekily titled ‘Not Right in the Head’. The article also mentions that the Neurophilosophy blog published a similar article two years ago, but rather surprisingly there was only one case that overlapped between the two.

The moral of the story is that if you can imagine it ending up in the brain, it probably has at some stage.

However, neither article mentions my all time favourite case, which involved a miniature fencing foil being lodged in the brain after being accidentally shoved through the nostrils (see a previous Mind Hacks post on things that have become stuck in the brain through the nose).

It was first reported in a 1968 article for the journal Neuropsychologia and just gives the following details:

N.A. (born July 9, 1938), a young American airman, was injured on December 15, 1960, while stationed at the Azores. The injury resulted from a mock duel with another serviceman, when a miniature fencing foil entered the patient’s right nostril and punctured the base of the brain, after taking an obliquely upward course, slightly to the left.

The case is not only notable for its strangeness, however, it is also one of the most important cases in the neuropsychology of memory.

NA suffered a dense amnesia, not unlike the famous Patient HM, without experiencing any other cognitive problems and while retaining his exceptional intelligence.

A major difference with HM was that HM had his hippocampi and surrounding tissue surgically removed on both sides while NA had a much smaller penetrating injury that largely affected his thalamus and a nearby pathway called the mammillothalamic tract – deep brain structures known to be widely connected to the brain’s outer cortical areas.

This was some of the first evidence that amnesia could be caused by damage to a ‘memory circuit’ and hence this type of conscious ‘declarative’ memory did not solely rely on the hippocampi, as was thought by some after the studies on HM.

We now know that damage to a circuit involving the hippocampus, fornix, mammillary bodies, the dorsalmedial nucleus of the thalamus and to a lesser extent, the septal nuclei, can cause strikingly similar amnesic problems and, hence, have been identified as key memory areas.

NA subsequently became one of the most studied patients in neuropsychology but because ‘NA’ is such a nondescript search term, in the age of the internet it has become easier to find studies on him by searching for “miniature fencing foil”.

A curious epitaph for such an important figure in our understanding of the brain.

Link to Inkling Magazine on unusual objects in the brain.
Link to Neurophilosophy on unusual penetrating brain injuries.

3 Comments

  1. Posted May 30, 2010 at 12:04 am | Permalink

    I can’t believe I didn’t come upon that one!
    Do we have any idea *how* miniature this fencing foil was? I’m having a hard time picturing the incident, which for maximum scientific enjoyment I would really like to be able to do.

  2. Simon
    Posted May 30, 2010 at 12:56 am | Permalink

    There are also several cases of amnesia resulting from damage to retrosplenial cortex, which makes sense, since it has strong connectivity with the rest of this network.

  3. Neuromancy.wordpress.com
    Posted May 30, 2010 at 1:17 am | Permalink

    I have a vague memory in one of my textbooks that it mentioned more than one case study resulting from fencing accidents, and I think one of them involved a neuropsychologist. I always had an image of frustrated memory researchers and their stooges trying to create focused brain legions in fencing clubs around the country!


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