Mega cisterna magna in bipolar mood disorder: a case report

Area of Science:

• Neurology
• Psychiatry
• Developmental Malformations

Background:

• Mega cisterna magna (MCM) is a posterior fossa malformation, often associated with the Dandy-Walker complex, characterized by a cisterna magna exceeding 10 mm without vermal or cerebellar hemispheric hypoplasia.
• Psychiatric disorders are infrequently reported in individuals with MCM, making the association between this anomaly and mental health conditions a subject of limited investigation.

Observation:

• A 28-year-old female presented with acute symptoms of irritability, insomnia, appetite changes, distractibility, agitation, and a delusion of reference.
• Neurological examination revealed no abnormalities, while cranial magnetic resonance imaging confirmed the presence of Mega cisterna magna.
• Clinical follow-up demonstrated increased energy and speech, consistent with manic symptoms.

Findings:

• The patient was diagnosed with bipolar disorder, presenting with a psychotic manic episode.
• This case establishes a rare clinical presentation of Mega cisterna magna associated with a severe mood disorder and psychosis.

Implications:

• The etiological relationship between Mega cisterna magna and psychiatric disorders, including bipolar disorder, remains unclear, necessitating further research.
• This case contributes to the literature by exploring the potential connection between cerebellar development anomalies and the manifestation of psychiatric symptoms.
• Further investigation is warranted to determine if the observed association is coincidental or indicative of a shared underlying pathophysiology.