Babington's aphasia--overcoming left hemisphere trauma

24 and a company commander in the 1st Dorset Regiment when he was wounded by shrapnel in Holland early in the morning of 2 November 1944, in the aftermath of the Arnhem campaign.His story is in his own writings 1,2 and in his army medical records 3 , both quite exceptional in detail and perception. CASE HISTORYHe was felled by the shell burst and briefly unconscious, and had sustained a left parietal penetrating injury which made him mute and hemiplegic.He was evacuated by stretcher, ambulance and plane.'During the flight I felt something stiff and cold on the right side of my chest.I puzzled about it for a while before it dawned on me that it was my right arm, heavy, insensate and quite paralysed . . .At one point I thought the end had come . ..' 2 .On the evening of the same day he reached the Military Hospital for Head Injuries at St Hugh's College, Oxford.X-rays showed 'a large MFB [metal foreign body] deep in the left parietal lobe just above the ventricular roof but may impinge on it.'On 3 November Major C A Calvert 4 operated on a semiconscious, globally aphasic man who had a right hemiplegia, hemianaesthesia, and hemianopia (Figure 1): '. . .wound stank horribly . . .contamination with hairs and dura down brain track-marked oedema . . .toothpaste brain and clot . . .bone chips indrawn about 2 cm, metallic body about 4 cm from cortex, inner end about 6 cm . . .debrided . . .many toothpaste pockets extending laterally from track . . .area of cortex destruction about 4 cmÂ4 cm . . .gush of CSF . . .ventricle into which MFB had protruded . . .5000 U penicillin . . .dura left open . . .drain . ..' 3 .After the operation Anthony Babington recalled 1,2 gesticulating with his left hand to indicate that he needed treatment for head pain, something to drink, or a urine bottle.When asked to write his home address with his left hand 'I knew exactly what I intended to write but I was dismayed to find myself drawing a series of short and very crooked lines . . .when shown a newspaper I could see letters but not understand them . . .might have been Chinese.'I woke one morning feeling slightly better.The night sister said ''You are over the worst and out of danger . . .The doctors think you might get back a little movement in your right side, in the leg at any rate.But I am afraid they think it unlikely that you will ever be able to speak again''.'