[Kleptomania before and after spontaneous subarachnoid hemorrhage--a neuropsychodynamic case report]

Kleptomania is not supposed to be a nosologic entity, but represents a psychopathological symptom of variant neurological and psychiatric diseases. A 47-year-old woman had shown a kleptomanic impulse disorder on the basis of a phobic personality organisation, until she suffered a spontaneous subarachnoidal haemorrhage with a consecutive basal forebrain lesion five years ago. After this event the kleptomanic symptom worsened dramatically. This case suggests an integrated "neuropsychodynamic" approach to clinical findings, which are commonly to be interpreted neuropsychologically and psychodynamically. We discuss the many mutual overlappings of neurobiologically determined and biographically understandable psychic phenomena.