Year: 2025 | Month: December | Volume: 12 | Issue: 12 | Pages: 267-270
DOI: https://doi.org/10.52403/ijrr.20251230
Post-Ictal Psychosis Manifestation Associated with Temporal Lobe Cavernoma
Olivia Vanya Wardoyo1, I Ketut Sumada2, Desie Yuliani2, Ni Made Kurnia Dwi Jayanthi2
1Intern-Department of Neurology, Wangaya Regional General Hospital, Denpasar, Bali, Indonesia
2Neurologist-Department of Neurology, Wangaya Regional General Hospital, Denpasar, Bali, Indonesia
Corresponding Author: Olivia Vanya Wardoyo
ABSTRACT
Background: Cavernoma or also known as cerebral cavernous malformation (CCM) is a developmental vascular anomaly characterized by clusters of small blood-filled cavities lined by a layer of endothelium. Only 20%-30% of affected individuals become symptomatic. Cavernoma usually manifest with convulsion, cerebral hemorrhage, persistent headache, and progressive neurologic deficit. Psychotic symptoms are uncommon. But a few were found in a case of frontal and temporal lobe cavernoma.
Case Presentation: A 68-year-old man with history of right temporal lobe cavernoma presented to emergency department with psychotic event, characterized by aggressive behavior and auditory hallucination. Patient was showing hostility towards his family members and these symptoms started after a tonic-clonic convulsion. On brain CT scan showed a result of hypodense lesion with multiple calcifications on the right temporal lobe suspected of artery-venous malformation (AVN). Angiography was done with findings of low-flow vascular malformation suggestive of CCM. MRI showed a blooming artefact consistent with the imaging characteristics of cavernoma.
Discussion: The classic presentation of cavernoma found in temporal lobe was usually convulsion. Psychotic episode was rarely found. Our patient presented with post-ictal psychosis which is one of the rare manifestations can be found in temporal lobe cavernoma.
Conclusion: While convulsion is the most frequent manifestation of temporal lobe cavernomas, this patient uniquely also presented with post-ictal psychosis, which is a rare phenomenon. Atypical clinical manifestations, such as psychotic episodes, should be recognised as possible clinical manifestations when diagnosing cavernoma.
Keywords: Cavernoma, Convulsion, Psychosis, Temporal Lobe
[PDF Full Text]