Organic mania has been reported to have multiple etiologies. A case is described of a patient who developed mania following a coronary artery bypass graft and mitral valve replacement. Cerebral abnormalities were not detected by computed tomographic or magnetic resonance imaging scans, but an area of dysfunction was found using single photon emission computed tomographic (SPECT) imaging. The lesion resolved when the patient became clinically asymptomatic. The area of decreased cerebral perfusion associated with the patient's mania was in an atypical location, raising questions about which brain regions can result in well-defined psychiatric syndromes.
Get full access to this article
View all access options for this article.
References
1.
RobinsonRG, BostonJD, StarksteinSE, PriceTR: Comparison of mania and depression after brain injury: Causal factors.Am J Psychiatry1988;145:172–178.
2.
CummingsJL, MendezMF: Secondary mania with focal cere-brovascular lesions.Am J Psychiatry1984;141:1084–1087.
3.
CummingsJL: Organic psychoses. Delusional disorders and secondary mania.Psychiatr Clin North Am1986;9:293–311.
4.
KrauthammerC., KlermanGL: Secondary mania. Manic syndromes associated with antecedent physical illness or drugs.Arch Gen Psychiatry1978;35:1333–1339.
5.
GrossRA, HerridgeP: A maniclike illness associated with right frontal arteriovenous malformation.J Clin Psychiatry1988;49:119–120.
6.
StarksteinSE, MaybergHS, BerthierML, et al: Mania after brain injury: Neuroradiological and metabolic findings.Ann Neurol1990;27:652–659.
RiessH., SchwartzCE, KlermanGL: Manic syndrome following head injury: Another form of secondary mania.J Clin Psychiatry1987;48:29–30.
9.
ShuklaS., CookBL, MukherjeeS, etal: Mania following head trauma.’ Am J Psychiatry1987;144:93–96.
10.
WilsonD., McLaughlinT: Cerebrovascular disease and secondary mania.Gen Hosp Psychiatry1990;12:271–275.
11.
HenriksenL: Evidence suggestive of diffuse brain damage following cardiac operations.Lancet1984;1:816–820.
12.
JampalaVC, AbramsR: Mania secondary to left and right hemisphere damage.Am J Psychiatry1983;140:1197–1199.
13.
OldfieldRC: The assessment and analysis of handedness: The Edinburgh inventory.Neuropsychology1971;9:97–113.
14.
MesulamMM, GeschwindN: On the possible role of neocortex and its limbic connections in the process of attention and schizophrenia: Clinical cases of inattention in man and experimental anatomy in monkey.J Psychiatr Res1978;14:249–259.
15.
GeschwindN: Disconnexion syndromes in animals and man. Parts I and II. Brain1965;88:237–294,585–644.
16.
MesulamMM: Patterns in behavioral neuroanatomy: Association areas, the limbic system, and hemispheric specialization, in MesulamMM (ed): Principles of Behavioral Neurology.Philadelphia, FA Davis, 1985, pp 1–70.
