Starkstein S E, Boston J D, Robinson R G
Department of Psychiatry and Behavioral Science, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205.
J Nerv Ment Dis. 1988 Feb;176(2):87-100. doi: 10.1097/00005053-198802000-00004.
Twelve patients who developed mania after a brain lesion are reported. Ages ranged from 20 to 83 years. Five patients had brain tumors (three frontal meningiomas, one temporal meningioma, and one temporal astrocytoma), four patients had stroke lesions (one frontal, one temporal, and two thalamocapsular), two patients had a traumatic frontal closed head injury, and one patient had a pituitary adenoma resection. Although seven patients had lesions restricted to the right hemisphere, four had bilateral or midline damage and one had a left hemisphere lesion. Damage to structures functionally connected to the obitofrontal cortex, mainly in the right hemisphere, seems to be associated with secondary mania. The possible roles of monoaminergic, genetic, and perinatal factors in the pathogenesis of secondary mania are discussed.
报告了12例脑损伤后出现躁狂的患者。年龄范围为20至83岁。5例患者患有脑肿瘤（3例额叶脑膜瘤、1例颞叶脑膜瘤和1例颞叶星形细胞瘤），4例患者有中风病灶（1例额叶、1例颞叶和2例丘脑囊），2例患者有创伤性额叶闭合性颅脑损伤，1例患者有垂体腺瘤切除术。虽然7例患者的病灶局限于右半球，但4例有双侧或中线损伤，1例有左半球损伤。主要在右半球与眶额皮质功能相连的结构受损似乎与继发性躁狂有关。讨论了单胺能、遗传和围产期因素在继发性躁狂发病机制中的可能作用。
