An officer suffered a traumatic brain injury after falling 4 meters during a search of an abandoned construction site. He experienced expressive aphasia and short-term amnesia due to damage to the left frontal lobe and hippocampus. Over several months his language abilities and memory gradually improved, but he was left with permanent aphasia and changed career prospects due to the incident, which was caused by his commander's neglect of safety procedures. The experience highlighted the complexity and fragility of the brain.

1. ONE SLIP CAN CHANGE
EVERYTHING
& Deliberate neglect can be
disguised as an “accident”

2. BEGINNING
➔ In December 2013, in the eastern part of Turkey, a
group of police officers were investigating an
abandoned construction site for illegal weapons that
might have been hidden there.
➔ What all of them had in common was that, they were
fulfilling their compulsory service in that city, where
terrorism has been on the rise for a long time.

3. ➔ The dangerous situation in that area meant those who
serve there were under constant risk of injury or
death, which was conveniently exploited by the police
commander in charge that night.
➔ Without any sensible security measurements
whatsoever, he sent his team into the pitch black
empty building to carry out their task.

4. ➔ Not surprisingly, but very unfortunately, a terrible
accident happened; an officer who was in his late-
twenties stepped forward to search an area but could
not see the free space before him in the darkness and
fell down from nearly 4 meters
➔ The major point of impact extended from the temple
to the back of the head on the right and from the
upper portion of ears to the back, forming an arc of
scar, on the left

5. SYMPTOMS & AFFECTED BRAIN AREAS
➔ Initially he displayed a difficulty in understanding the words as well as
speaking himself, but in time his understanding of speech improved
though he could not form meaningful sentences. In addition, for a short
time he remained amnesic; he obviously had no idea what happened to
him and had to be told the account of events over and over again. After
several days his amnesia had subsided.
◆ Deduction: Apparently, damage to his left frontal lobe affected
Broca’s area, resulting in severe expressive aphasia accompanied by
mild receptive aphasia. Also, his short-lived amnesia suggests
temporary loss of hippocampal function.

6. Broca’s Area Hippocampus
- Located in the left frontal lobe in approximately 90% of
people, in close proximity to motor cortex
- Motor center of speech, responsible for speech formation,
also has a role in sentence processing
- In case of injury, expressive aphasia occurs (also due to its
role in syntactic processing, some degree of difficulty in
comprehension may be observed)
www.strokecenter.org
- Located in the medial temporal lobe on both hemispheres
- Plays an important role in memory consolidation, especially in
the formation of semantic memory and in the formation &
reconsolidation of episodic memory
- Most common symptom of damage is amnesia (particularly
anterograde amnesia)
www.brainmadesimple.com

7. ➔He had no problems in moving his arms or
legs, indicating his spinal cord was spared.
Also his visual and auditory sensory systems
were unaffected. But he had ptosis and
facial palsy on the left side of his face, thus
it can be inferred that his brainstem
(presumably midbrain and pons) was
damaged mostly on the left side.

8. Brainstem
- Consists of midbrain, pons and medulla, located posteriorly in the brain
(continuous with the spinal cord)
- Midbrain functions in most eye movements such as adduction, looking
up and eyelid movement
- Pons is responsible for facial expressions and eye abduction, as well
as chewing
- Medulla oblongata has a role in controlling upper airway muscles
(swallowing, forming the sounds needed for speech etc) and tongue
movements
http://en.wikipedia.org/wiki/File:1311_Brain_Stem.jpg

9. PROGNOSIS
➔ Several months after getting discharged from the hospital, although he could completely
understand what was being told to him, he was still suffering from amnesic aphasia. His family
labelled the furnitures with post-it notes to help him memorize the names. His daily routine
involved studying from a book that shows the pictures of objects with their names. When
tested, he took his time but eventually could find out the particular word for a given object.
➔ Due to his facial palsy, he could not speak in an understandable manner. But in time he
regained the ability to express himself by writing very simple sentences.
➔ He was also able to repeat the words clearly after someone spelled them out.
➔ His amnesic aphasia and written expression is expected to recover gradually in time, but he
will most probably never be able to speak as he did before.

10. ➔ Of course, he and his family were quite devastated. But they felt grateful that he could
survive it and remain physically autonomous as well.
➔ But he deeply valued his job, and now his entire career outlook has changed and his only
viable choice is to leave the streets and settle himself to indoor work.
➔ And the one thing that really hurt him emotionally was that, the commander whose careless
conduct led to this tragedy was not really interested in consoling him in anyway, far less take
responsibility for this unfortunate outcome. He felt quite betrayed, and rightly so, that his
whole life was so easily upturned and although simple precautions could have prevented this
from happening, the incident was viewed as an inevitable accident. Still, his hopeful and
forgiving attitude never changed, which is deeply moving...

11. ➔In the end, what amazes me is the strength
of will humans possess without even
knowing it until they have to call upon it.
There is something to be learned from the
experiences of those who underwent such
tragedies and obviously, what is lost
healthwise somehow adds up to the
resilience and character.

12. ➔ What I’ve learned in this course made me appreciate the smallest things in life. For now we
know that everything we take for granted, moving, seeing, talking, even thinking or feeling, is
a result of very much complex and perhaps somewhat fragile processes, which may go wrong
at some point…
➔ Getting to know the brain is a bit confusing. It’s like looking at yourself from the outside, as if
in a dream, yet you are located in yourself anyway. How brain works is how “we” work, in a
sense. So every bit of knowledge gives me a feeling of being control of my existence, yet the
very first lesson about brain is that what we do not know or understand far exceeds what we
can. So you are filled with a sort of scientific curiosity, even an artistic appreciation, and
endless inner debates of philosophical uncertainty.
➔ But all in all, we are basically very sophisticated networks and I sincerely hope soon we will be
able to identify the respective components and their interactions to such an extent that no
one will have to suffer from a failure in any one of them.

13. REFERENCES
1) The Incredible Prof. Mason and her amazing
course!
“Understanding the Brain: The Neurobiology
of Everyday Life”, www.coursera.com