Exposure to intense radiation may also be a factor – feral ghouls have no body heat and emit lethal levels of radiation, indicating that feral ghouls are for all intents and purposes dead, their functions sustained only by their high irradiation. The factors that may cause a ghoul to enter this state are unclear, but anti-social or isolated ghouls are more susceptible to it. When the loss of capacity for thought is complete, a ghoul is considered feral. It is known that it is a result of a degeneration of the brain (which is not affected by the regenerative mutation of the spinal cord) and emerges following the atrophy of higher brain functions, accompanied by an increased level of aggression and appetite. The degeneration into a feral state (referred to as ferocious post-necrotic dystrophy) is not fully understood. To change it, please edit the transcluded page. This section is transcluded from feral ghoul. In most cases, exposure to radiation in the post-War Commonwealth wastes degenerated their brains, causing them to lose their higher cognitive functions, turning them into mindless, radiation-resistant cannibals. Becoming permanently irradiated, they were disfigured and their lifespans were increased virtually indefinitely.

Many ghouls are pre-War humans who survived the initial nuclear bombardment. Ghouls are former humans who have become horribly irradiated by the radioactive fallout covering the wasteland from the Great War.

Fallout 4 play as ghoul