Obsessive-compulsive disorder secondary to bilateral frontal damage due to a closed head injury

• Published in: Cognitive and behavioral neurology Vol. 17; no. 2; pp. 118 - 120
• Main Authors: Bilgic, Basar, Baral-Kulaksizoglu, Isin, Hanagasi, Hasmet, Saylan, Mete, Aykutlu, Ebru, Gurvit, Hakan, Emre, Murat
• Format: Journal Article
• Language: English
• Published: United States 01-06-2004
• Subjects: Adult; Frontal Lobe - injuries; Functional Laterality; Head Injuries, Closed - complications; Head Injuries, Closed - psychology; Humans; Magnetic Resonance Imaging; Male; Mood Disorders - etiology; Mood Disorders - psychology; Obsessive-Compulsive Disorder - etiology
• ISSN: 1543-3633
• DOI: 10.1097/01.wnn.0000117862.44205.ea

To describe a patient who exhibited obsessive-compulsive disorder and frontal lobe dysfunction signs after a closed head trauma.
Recent evidence indicates that frontal-subcortical circuits are involved in the pathogenesis of primary obsessive-compulsive disorder. There are a number of case reports of secondary obsessive-compulsive disorder after lesions involving certain parts of these circuits.
Clinical examinations, cognitive and behavioral assessments, and-lesion analysis based on magnetic resonance imaging were conducted.
The patient displayed marked obsessive-compulsive behavior along with hyperorality and apathy. Magnetic resonance imaging showed symmetrical frontal-polar abnormal signal intensity. Topographic lesion analysis revealed involvement of Brodmann areas 11, 10, 24, 25, and 32.
The patient presented in this report had both frontal lobe dysfunction signs and obsessive-compulsive disorder secondary to bilateral frontal damage due to a closed head injury. The etiological significance of head injury and frontal lobe involvement in obsessive-compulsive disorder is discussed in the context of the clinical and neuroimaging findings and of previous series of brain injured patients.