2026 American Academy of Neurology Abstract Website

Objective:

To shed light on a second reported case in the literature of a patient with personality change after ventriculostomy

Background:

Frontal lobe syndromes are rarely reported complications in ventriculostomy procedures. Phineas Gage had a metal rod that pierced his frontal lobe. Little is known about how a ventriculostomy procedure may result in idiopathic personality change.

Design/Methods:

Results:

A 67-year-old woman presented to the Neurology clinic with abrupt-onset cognitive and personality changes after ventriculostomy for subarachnoid hemorrhage during coiling for an aneurysm 6 years prior. Her husband reported that he and his children no longer recognized the woman who came home with them after the procedure. She dressed differently, preferred different foods, engaged in new hobbies, and was apathetic and disinhibited. MRI Brain revealed chronic encephalomalacia around the ventricular drain route in the frontal lobe; Based on the MRI and neurocognitive evaluation, a diagnosis of frontal lobe syndrome or “Phineas Gage syndrome” was made. A literature review identified only one similar case of personality changes after a ventriculostomy. Additionally, other permanent neurocognitive complications were reported in 1% of patients with ventriculostomy according to one review article.

Conclusions:

This report reveals another case of a post-frontal lobe approach ventriculostomy procedure that resulted in personality, neuropsychiatric and cognitive changes. The case provides historical insight of Phineas Gage and how frontal lobe lesions caused by ventriculostomy cause similar frontal lobe syndrome . These complications may be underreported, and clinicians should be aware of the potential long-term complications when entering this region of the brain.