Third Ventricular Colloid Cyst - An Organic Cause of Mania: A Case Report

Abstract

Background: Psychiatric manifestations due to space-occupying lesions, although not uncommon, are generally misdiagnosed, leading to an unfavorable outcomes. Colloid cyst is a slow-growing, benign tumor in the anterior part of the third ventricle, which frequently presents with neurological complaints like headache and gait disturbances. However, a patient with colloid cyst may also present to the OPD with a spectrum of psychiatric symptoms. Case Report: We here report a middle-aged man who was brought to the OPD with symptoms of pervasive irritability and disinhibited behavior for three months, along with complaints of increased activity, reduced sleep and appetite, suspicious about wife, family members and neighbors. Patient had frequent episodes of headache in the past 3 months associated with nausea, restlessness for which neuroimaging was advised, which showed a hyper-dense lesion in the third ventricle. Patient was referred to neurosurgery and was operated for the same. Post-operatively, family members reported improvement in his behavior. Conclusion: A detailed systemic evaluation for any neurological causes of organic causes or atypical picture of psychiatric conditions is of extreme necessity. There is a dire need for liaison of psychiatrists with neurophysicians and neurosurgeons to attain betterment in patients in both physical as well as psychological aspects, especially in psychiatric diagnosis with organic causes.