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Right frontal injury often has been associated with development of manic behavior. Reports of similar behavior change with left-sided frontal damage are rare. We report a patient who developed hypomania after removal of an arteriovenous malformation (AVM) from the left frontal lobe.
Case report.
A 41-year-old right-handed computer programmer developed crescendo bitemporal headaches brought on by lying down. Medical history included excision of an occipital meningocele at 3 weeks of age, brief loss of consciousness in a sporting accident, and sinus and cluster headaches. The patient took no medications and had no history of substance abuse. The neurologic examination gave normal results. MRI (figure, A and B) demonstrated a 2.5-cm diameter AVM in the left dorsolateral prefrontal cortex as well as mild, left greater than right, ventricular enlargement. On cerebral arteriography, the AVM arterial supply originated from the middle and anterior cerebral …
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