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It has been 15 years since Kaplan-Solms and Solms published their Clinical Studies in Neuropsychoanalysis, where they proposed a neuroanatomy of the mental apparatus. One of their main observations was that damage to certain areas of the left prefrontal cortex (PFC), particularly those related to expressive language (Brocas area), did not generate changes in the mental apparatus. However, a limitation of their model was that it did not include patients with damage to other areas of the left PFC. The main goal of this paper is to update Kaplan-Solms and Solms model through the description of id, ego and superego changes in a case of left dorso-medial prefrontal damage (Professor F). Data from a 7-year psychoanalytic psychotherapy with Professor F were collected through the review of clinical notes and session voice recordings. This material was analyzed under the light of existing evidence on the neuropsychological functions supported by the left dorso-medial PFC. Results from this analysis support the hypothesis that damage to other areas of the left PFC, beyond Brocas area, can in fact generate deep changes in the mental apparatus. The most remarkable change observed here was a modification of the dynamic functions of the ego, as an inability to regulate affect via preconscious verbal thinking. This transformation impacted the baseline arrangement between ego and id, with somatic states becoming more salient. Finally, changes in the superego were also observed, particularly in relation to its flexibility during moments of conflict, or the silencing of superego voices outside moments of negative arousal.