Sublieutenant Zasetsky, aged twenty-three, suffered a head injury 2 March 1943 that penetrated the left parieto-occipital area of the cranium. The injury was followed by a prolonged coma and, despite prompt treatment in a field hospital, was further complicated by inflammation that resulted in adhesions of the brain to the meninges and marked changes in the adjacent tissues. The formation of scar tissue altered the configurations of the lateral ventricles by pulling the left lateral ventricle upward and producing an incipient atrophy of the medulla of this area.
Some alarming conclusions follow from these data. The bullet had lodged in the posterior parieto-occipital regions of the brain and destroyed the tissue in this area, an injury further complicated by inflammation. Though a local rather than an extensive wound, limited only to areas of the brain adjacent to the site of injury, it had done irreversible damage to the parieto-occipital regions of the left hemisphere, and the formation of scar tissue inevitably produced a partial atrophy of the medulla which in time was bound to become more extensive.
A dreadful fate awaits someone who is suffering from progressive, irreversible atrophy of this part of the brain. In this case, what symptoms had it produced and still threatened to create? How does the particular kind of injury this man suffered account for the entire syndrome we have just described?