title: Manic episode after ventricular-peritoneal shunt replacement in a patient with radiation-induced hydrocephalus: the role of lifetime subthreshold bipolar features.
abstract: We present a case report of a woman hospitalized for a ventricular-peritoneal shunting replacement, who developed a manic episode with psychotic symptoms after hydrocephalus resolution. We have no knowledge of cases of manic episodes due to hydrocephalus resolution by ventricular-peritoneal shunt replacement, although previous case reports have suggested that hydrocephalus might induce rapid-onset affective episodes or mood cycles. The patient's history revealed the lifetime presence of signs and features belonging to the subthreshold bipolar spectrum, in absence of previous full-blown episodes of a bipolar disorder. Our hypothesis is that such lifetime sub-threshold bipolar features represented precursors of the subsequent full-blown manic episode, triggered by an upregulated binding of striatum D2 receptors after the ventricular-peritoneal shunt replacement.
authors: Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 57, 56100, Italy.
authors: Antonio
authors: A
authors: Callari
authors: European Assessment Office, Italian Medicines Agency (AIFA) Via del Tritone 181, 00187 Rome, Italy.
authors: Valentina
authors: V
authors: Mantua
authors: Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 57, 56100, Italy.
authors: Mario
authors: M
authors: Miniati
authors: Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 57, 56100, Italy.
authors: Antonella
authors: A
authors: Benvenuti
authors: Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 57, 56100, Italy.
authors: Mauro
authors: M
authors: Mauri
authors: Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 57, 56100, Italy.
authors: Liliana
authors: L
authors: Dell'osso