Department of Psychiatry and Psychology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Department of Psychiatry, 'Prof. Dr. Alexandru Obregia' Clinical Hospital of Psychiatry, 041914 Bucharest, Romania.
Medicina (Kaunas). 2022 Apr 24;58(5):586. doi: 10.3390/medicina58050586.
Porencephaly, a rare disease affecting the central nervous system, is represented by a cerebrospinal fluid-filled cavity in the brain. There are two types of porencephalic cavities: congenital and acquired. Porencephaly is mainly associated with neurological and developmental consequences. Associated psychotic symptoms were reported in a few cases, and due to this fact, there is a knowledge gap regarding the diagnostic and therapeutic approach to such cases. We present the case of a 32-year-old male diagnosed with a psychotic disorder associated with acquired porencephaly. The porencephalic cystic lesions were most probably due to a traumatic brain injury at the age of 6 years old. The psychotic symptomatology consisted of interoceptive/visceral hallucinations, delusions with persecutory and religious/magic content and disorganised behaviour. The porencephalic cavity was confirmed by a computed tomography scan. The patient was treated over the course of time with risperidone, olanzapine and zuclopenthixol. The existing literature regarding other cases of psychosis associated with porencephaly is discussed. In conclusion, even though porencephaly was asymptomatic for a long period of time, we argue that there is a causal relationship between the chronic psychotic symptoms and the porencephalic cyst in our case.
脑裂畸形，一种罕见的中枢神经系统疾病，表现为大脑中有充满脑脊液的腔隙。脑裂畸形有两种类型：先天性和获得性。脑裂畸形主要与神经和发育后果有关。少数病例报告了相关的精神病症状，由于这一事实，对于这种病例的诊断和治疗方法存在知识空白。我们介绍了一例 32 岁男性，诊断为与获得性脑裂畸形相关的精神病障碍。裂脑囊性病变很可能是由于 6 岁时的脑外伤引起的。精神病症状包括内脏幻觉、有被害和宗教/魔法内容的妄想以及行为紊乱。通过计算机断层扫描确认了脑裂畸形。该患者在病程中接受了利培酮、奥氮平和齐拉西酮治疗。我们讨论了其他与脑裂畸形相关的精神病病例的现有文献。总之，尽管脑裂畸形在很长一段时间内没有症状，但我们认为在我们的病例中，慢性精神病症状与脑裂囊性病变之间存在因果关系。
