Orbitofrontal syndrome after a cerebral aneurysm operation. A case report

Abstract

Introduction. Orbitofrontal syndrome is an organic mental disorder characterized by cognitive, affective and behavioral alterations, triggered by the suppression of the inhibiting cerebral mechanisms.

Clinical case. A 19 year-old woman developed a «change of personality» in the context of an aneurysm operation in the middle cerebral artery, with serious behavioral alterations during one year. After the drug treatment was established, there was significant reduction in the intensity of the psychopathology. Furthermore, the utility of psychotherapy in the improvement of the familiar management was affirmed.

Conclusions. Orbitofrontal syndrome implies damage to any of the structures and connections included in the orbitofrontal system. The psychopathological overlapping with some psychiatric disorders opens the possibility of greater understanding of the biological bases of the mental disease. Because of the deficit in the metacognitive capacity and high dependency on environmental stimuli, it seems that behavioral techniques such as psychotherapy would be the treatments of choice for this type of patient.