Obsessive-Compulsive Disorder Following Cerebrovascular Accident: A Case Report and Literature Review

J Stroke Cerebrovasc Dis. 2019 Apr;28(4):e17-e21. doi: 10.1016/j.jstrokecerebrovasdis.2018.12.034. Epub 2019 Jan 9.

Abstract

Background: Cases of obsessive-compulsive disorder (OCD) following cerebrovascular accident (CVA) have rarely been reported.

Methods: Case report and literature review.

Results: We describe the case of a 58-year-old, right-handed man developed OCD 17 months after stroke resulting from lesion of the right middle cerebral artery infarction. The patient was successfully treated with sertraline up to 50 mg per day. His OCD behaviors largely reduced in 6 weeks, and the Yale-Brown Obsessive Compulsive Scale score was reduced from 29 to 12 in 1 year. A literature review revealed 21 previous cases of OCD following CVA. Among these, consistent with our case, the basal ganglia was the most common site of the lesion responsible for the development of this rare disorder. We discuss the patient's treatment and outcomes.

Conclusions: Our present case and a literature review suggest that OCD can manifest following CVA, although further studies are necessary. Selective serotonin reuptake inhibitors appear to be effective in treating this rare disorder.

Keywords: Obsessive-compulsive disorder; basal ganglia; cerebrovascular accident; sertraline; stroke.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Cerebral Angiography / methods
  • Cerebrovascular Circulation
  • Endovascular Procedures / instrumentation
  • Humans
  • Infarction, Middle Cerebral Artery / complications*
  • Infarction, Middle Cerebral Artery / diagnosis
  • Infarction, Middle Cerebral Artery / physiopathology
  • Infarction, Middle Cerebral Artery / therapy
  • Magnetic Resonance Angiography
  • Male
  • Mental Status and Dementia Tests
  • Middle Aged
  • Obsessive-Compulsive Disorder / diagnosis
  • Obsessive-Compulsive Disorder / drug therapy
  • Obsessive-Compulsive Disorder / etiology*
  • Obsessive-Compulsive Disorder / psychology
  • Selective Serotonin Reuptake Inhibitors / administration & dosage
  • Sertraline / administration & dosage
  • Stents
  • Thrombolytic Therapy
  • Tomography, Emission-Computed, Single-Photon
  • Treatment Outcome

Substances

  • Serotonin Uptake Inhibitors
  • Sertraline