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An unusual association of headache, epilepsy, and late-onset Kleist’s pseudodepression syndrome in frontal lobe cavernoma of the cerebral left hemisphere

Authors Chirchiglia D, Della Torre A, Murrone D, Chirchiglia P, Marotta R

Received 29 January 2017

Accepted for publication 22 March 2017

Published 5 May 2017 Volume 2017:10 Pages 163—166


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Professor Ronald Prineas

Domenico Chirchiglia,1 Attilio Della Torre,1 Domenico Murrone,2 Pasquale Chirchiglia,3 Rosa Marotta4

1Department of Neurosurgery, Neurophysiopathology Unit, University of Catanzaro “Magna Graecia”, Catanzaro, 2Neurosurgery Department, Di Venere Hospital, Bari, 3School of Medicine, University of Catanzaro, Catanzaro, 4Department of Medical and Surgical Sciences, University of Catanzaro, Catanzaro, Italy

Abstract: Cerebral cavernous angioma or cavernoma is a benign vascular malformation, usually asymptomatic. It is infrequent and often its discovery is incidental, a so-called incidentaloma. However, these lesions can be symptomatic, causing headaches, epilepsy, cerebral hemorrhage and other neurological signs depending on the brain area involved. Frontal localization is responsible for psychiatric disorders, particularly the prefrontal region, leading to prefrontal syndrome, a condition common in all frontal lobe tumors. Psychopathological syndrome can be depression-type, pseudodepression syndrome or maniac-type, pseudomaniac syndrome. Surgical treatment of lesions like this may not always be possible due to their location in eloquent areas. In this study, we describe an unusual association of migraine-like headache, epilepsy and frontal lobe pseudodepression late-onset syndrome in the same patient. We have considered this case interesting mainly for the rarity of both a headache with migraine features and for the late onset of pseudodepression syndrome. Pathophysiology underlying migraine-like headache and that concerning the late-onset pseudodepression frontal lobe syndrome seems to be unclear. This case leads to further hypotheses about the mechanisms responsible for headache syndromes and psychopathological disorders, in the specific case when caused by a cerebral frontal lobe lesion.

Keywords: cerebral cavernoma, cavernous angioma, headache, frontal syndrome, pseudodepression syndrome

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