title: Obsessive compulsive disorder due to a cavernous malformation hemorrhage in the dominant caudate head.
abstract: Structural lesions of the basal ganglia may lead to obsessive compulsive disorder (OCD). We report a 31-year-old woman who developed OCD after a previously asymptomatic left caudate intracerebral cavernous malformation (ICM) hemorrhaged. Her neurologic examination was normal. Her OCD required hospitalization and improved with medication and therapy. The pathophysiology of this psychiatric disorder probably reflects a frontal cortex deafferentation mechanism. In patients with known ICM, any abrupt change in neurologic or psychiatric symptoms should prompt repeat imaging to assess for hemorrhage.
authors.affiliation: Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
authors.forename: Brian S
authors.initials: BS
authors.lastname: Katz
authors.affiliation: Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. Electronic address: flemming.kelly@mayo.edu.
authors.forename: Kelly D
authors.initials: KD
authors.lastname: Flemming
mesh_terms: D000328:Adult; D002421:Caudate Nucleus; D005260:Female; D020786:Hemangioma, Cavernous, Central Nervous System / Q000150:complications* / Q000523:psychology; D006760:Hospitalization; D006801:Humans; D020300:Intracranial Hemorrhages / Q000150:complications* / Q000523:psychology; D008279:Magnetic Resonance Imaging; D009771:Obsessive-Compulsive Disorder / Q000209:etiology* / Q000523:psychology / Q000628:therapy; D017397:Prefrontal Cortex / Q000473:pathology; D016896:Treatment Outcome
keywords: Cavernoma; Cavernous malformation; Obsessive compulsive disorder; Psychiatric