Right-hemispheric fronto-temporal injury leading to severe autobiographical retrograde and moderate anterograde episodic amnesia - implications for the anatomy of memory

Neuropsychological and neuroradiological data are reported for a 56 year old patient, DD, with traumatic brain injury. Prior to injury the patient had been a top specialist in his professional field and had obtained a doctor's degree. Hit by a bus. DD received major right sided damage to his frontal skull. resulting in loss of right eye vision, and extensive right prefrontal and anterior temporal damage. In addition the anterior right basal ganglia and the inferior anterior left frontal lobe were damaged together with the genu of the corpus callosum. The patient was repeatedly tested neuropsychologically 2 to 3 years post-injury. He was depressed and manifested moderate anterograde and severe autobiographical retrograde amnesia. His anterograde memory problems seem to be a consequence of reduced cognitive flexibility and inefficient structuring and active self-organization abilities, caused by his prefrontal damage. His retrograde amnesia is interpreted as related to the combined temporo-frontal damage in the right hemisphere which has been shown to result in precisely this deficit pattern in other patients with the same pattern of brain damage. It is concluded that fronto-temporal brain damage, largely restricted to the right hemisphere, results in an inability to retrieve or ecphorize autobiographical old memories.