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Someone that looks normal at first glance and appears to be a fully functioning human being, but in fact suffers from a severe mental illness or retardation.
Insinuates that the inside of someones head is like an unsolved puzzle and does not function correctly.
-Shit! that guy is petting that ladies dog WAY TOO HARD! whats his deal?

-Puzzle head bro, doesn't even know its a dog"
by the throwdown August 17, 2010