Obsessive-compulsive disorder secondary to bilateral frontal damage due to a closed head injury
Basar Bilgic1, Isin Baral-Kulaksizoglu, Hasmet Hanagasi
1Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey. bilgicb@tr.net
Objective:
To describe a patient who exhibited obsessive-compulsive disorder and frontal lobe dysfunction signs after a closed head trauma.
Background:
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.
Method:
Clinical examinations, cognitive and behavioral assessments, and-lesion analysis based on magnetic resonance imaging were conducted.
Results:
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.
Conclusions:
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.
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