224 Introduction to Anatomy and Physiology
of coordination, confusion, and agitation. Cases
of moderate and severe TBI require immediate
medical care, with the goal of preventing further
brain injury. X-rays and imaging tests may be
performed to help with assessment of the nature
and extent of the damage. Maintaining proper
blood pressure and fl ow of oxygenated blood to
the brain and throughout the body are priorities.
Furthermore, about 50% of severe TBI cases
require surgical repair.
Case Study: Phineas Gage. A miraculous story
of survival
from a signifi
cant TBI is the case of
Phineas Gage, a railroad construction foreman
who was injured in 1848 at 25 years of age. Gage
and his crew were blasting rock to make way
for railroad construction outside the town of
Cavendish, Vermont, when a 3½ foot iron rod
was accidentally blasted through Gage’s skull.
The iron entered below the left cheekbone and
exited through the top of the skull. The blast was
of such force that the iron landed approximately
80 feet away.
Amazingly, within a few minutes Gage was
able to speak, walk, and ride upright in a cart
back to his home, where he received medical
attention. Gage’s recovery was slow, with
advances and declines, including time spent in
a coma due to brain swelling. Nevertheless, his
physical recovery was complete.
Accounts of Gage’s mental recovery vary,
but they suggest that his personality was
negatively altered. Gage survived for 12 years
after the accident. He began to suffer a series
of increasingly severe seizures that eventually
resulted in his death. The case of Phineas Gage is
still discussed in medical and neurology classes.
Treating and Preventing TBI. Today, follow-
up care for TBI involves individualized
rehabilitation programs that may include
physical, occupational, and speech language
therapies; psychiatry; and social support. The
prognosis for those who have suffered from
a traumatic brain injury varies greatly, with
potential for lingering problems with intellectual
functioning, sensation, and behavior. Serious
head injuries can result in an unresponsive state
or a coma.
Research is being conducted in scientifi c
and clinical settings to achieve a clearer
understanding of the biological effects of TBI.
One goal of this research is to develop strategies
and interventions that limit the brain damage
that occurs during the fi rst few days after a head
injury. Another goal is to develop more effective
therapies for facilitating recovery of function.
Cerebral Palsy
Cerebral palsy (CP) is a group of nervous
system disorders caused by damage to the brain
before or during birth (congenital defect), or in
early infancy. Congenital defects that can cause
CP include a brain that has an abnormal shape or
structure, or damaged nerve cells and brain tissues.
Infections such as rubella in the mother during
pregnancy can produce CP. During the fi rst two
years, while the brain is still developing, several
conditions—including brain infections, head
injury, and impaired liver function—can cause
CP. Sometimes, however, the cause is unknown.
The most common symptoms involve
varying degrees of motor function impairment,
but can also include hearing, seeing, and cognitive
impairment. The degree of impairment may be
barely noticeable or very severe (Figure 6.22). One
or both sides of the body may be affected and the
arms, legs, or both may be involved.
Martynova Anna/Shutterstock.com
Figure 6.22 Russian and British athletes with
cerebral palsy play a game of soccer in preparation
for the Paralympics.