Bokhari Syed Ali, Elnoor Muhanad, Al Mansour Alma, Mustafa Khalid, Osman Abdelaziz
Psychiatry, Al Amal Psychiatric Hospital, Emirates Health Services, Dubai, ARE.
Emergency Medicine, Al Qassimi Hospital, Emirates Health Services, Sharjah, ARE.
Cureus. 2024 Aug 29;16(8):e68101. doi: 10.7759/cureus.68101. eCollection 2024 Aug.
The exclusion of organic causes for psychiatric symptoms is a routine practice in mental healthcare. Brain tumors can elicit a range of mood, behavioral, or cognitive symptoms that mimic mental health disorders, significantly altering a patient's personality and behavior if left undiagnosed or untreated. This case report presents a 56-year-old Middle Eastern male with no prior history of mental illness who exhibited a three-week history of depressive symptoms, social withdrawal, and poor self-care. Despite treatment, his condition deteriorated, manifesting psychomotor retardation, urinary incontinence, paranoia, mood lability, and sexually disinhibited behavior. Neuroimaging revealed a large extra-axial mass in the anterior cranial fossa, indicative of a meningioma, necessitating referral to neurosurgery. CT and MRI scans confirmed a hyperdense mass lesion (7.1 x 7.7 x 7.5 cm), causing structural erosion and a midline shift. This case underscores the importance of considering organic causes in atypical psychiatric presentations. Meningiomas, particularly those in the frontal lobes, can present primarily with psychiatric symptoms, complicating early diagnosis. Neuroimaging is critical for accurate diagnosis and effective management in such cases. Clinicians should be vigilant for organic causes in patients with atypical psychiatric symptoms, especially in those over 50. Early neuroimaging can lead to timely diagnosis and treatment, significantly improving patient outcomes.
在精神卫生保健中，排除精神症状的器质性病因是一种常规做法。脑肿瘤可引发一系列情绪、行为或认知症状，这些症状酷似精神健康障碍，如果未被诊断或治疗，会显著改变患者的性格和行为。本病例报告介绍了一名56岁的中东男性，他既往无精神疾病史，出现了为期三周的抑郁症状、社交退缩和自我照料不佳的情况。尽管接受了治疗，他的病情仍恶化，表现出精神运动迟缓、尿失禁、妄想、情绪不稳定和性抑制行为。神经影像学检查显示颅前窝有一个巨大的轴外肿块，提示为脑膜瘤，需要转诊至神经外科。CT和MRI扫描证实有一个高密度肿块病变（7.1×7.7×7.5厘米），导致结构侵蚀和中线移位。本病例强调了在非典型精神症状表现中考虑器质性病因的重要性。脑膜瘤，尤其是额叶的脑膜瘤，可能主要表现为精神症状，使早期诊断复杂化。在此类病例中，神经影像学检查对于准确诊断和有效管理至关重要。临床医生应对有非典型精神症状的患者，尤其是50岁以上的患者警惕器质性病因。早期神经影像学检查可实现及时诊断和治疗，显著改善患者预后。
