Are there documented cases of brain damage to regions that make someone lose a sense/ability to express self-?

There have been many cases of brain damage to regions of the brain that let people see what that part of the brain is for. Are there any cases/regions that damage causes a lost sense of self-awareness, and, if so, where/what else does that damage affect?Are there documented cases of brain damage to regions that make someone lose a sense/ability to express self-?
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http://www.mc.maricopa.edu/anthropology/鈥?/a>





all rights owned by the author James Shreeve





What Happened to Phineas?





Attend the tale of Phineas Gage. Honest, well liked by friends and


fellow workers on the Rutland and Burlington Railroad,


Gage was a young man of exemplary character and promise until one day


in September 1848. While tamping down the


blasting powder for adynamite charge, Gage inadvertently sparked an


explosion. The inch-thick tamping rod rocketed through


his cheek, obliterating his left eye on its way through his brain and


out the top of his skull. The rod landed several yards away,


and Gage fell back in a convulsive heap. Yet a moment later he stood


up and spoke; his fellow workers watched, aghast, then


drove him by oxcart to a hotel, where a local doctor, one John Harlow,


dressed his wounds. As Harlow stuck his index fingers


into the holes in Gage's face and head until their tips met, the young


man inquired when he would be able to return to work.





Within two months, the physical organism that was Phineas Gage had


completely recovered--he could walk, speak, and


demonstrate normal awareness of his surroundings. But the character of


the man did not survive the tamping rod's journey


through his brain. In place of the diligent, dependable worker stood a


foulmouthed and ill-mannered liar given to extravagant


schemes that were never followed through. ';Gage,'; said his friends,


';was no longer Gage.





This past year neurobiologists Hanna and Antonio Damasio of the


University of Iowa finally pinpointed what Gage had lost.


The Damasios had long been interested in the case; in the intervening


century it had become a classic in neurology textbooks.


The scientific interest had begun with John Harlow, who on hearing of


Gage's death in an epileptic fit 13 years after the


accident persuaded the family to exhume the remains and donate the


skull to medical research. Harlow believed that the


change in Gage's personality had been wrought by damage to the frontal


lobes of the brain. ';The equilibrium . . . between his


intellectual faculties and animal propensities seems to have been


destroyed,'; Harlow wrote.





But nineteenth-century science had a hard time accepting the notion


that a dollop of gray jelly could govern something so


transcendent as social behavior. ';Harlow was never given much credit,';


says Antonio Damasio. ';Some people didn't even


believe that Gage's story had ever happened.





So the Damasios decided, 130 years after the fact, to do an


autopsy--to track down where, exactly, the damage in Gage's


brain had occurred. Guided by anatomic clues on Gage's battered skull,


now preserved in the Warren Medical Museum at


Harvard, Hanna Damasio used computer modeling and neural imaging


techniques to determine the path the tamping rod had


taken through the brain. The most likely trajectory by far, the


Damasios found, would have spared the regions of the frontal


lobes necessary for language and motor function. But it would have


done ruinous damage to a portion of the underbelly of the


frontal lobes called the ventromedial region, especially on the left


side.





Apparently the loss of that region is what made Gage so antisocial.


This did not surprise the Damasios; in present-day patients


whose ventromedial region has been damaged by tumor, accident, or


surgery, they have observed the same sort of personality


change as Gage's. But it was gratifying to solve a case that was at


the root of so much modern research--and at the same time


to pay homage to an underappreciated predecessor. ';Gage's story was


the historical beginnings of the study of the biological


basis of behavior,'; says Antonio Damasio, ';and the location of his


lesion had always been a mystery. This was a way to give


poor Dr. Harlow his due.'; --James Shreeve