Obsessive compulsive disorder due to a cavernous malformation hemorrhage in the dominant caudate head

Obsessive-compulsive symptoms in two patients with strategic basal ganglia lesions

“…Obsessive-compulsive disorder (OCD) is a severe mental condition neuroanatomically characterized by cortico-striato-thalamo-cortical (CSTC) loop dysfunction [1], but also involves alterations in other networks [1,2] as well as molecular and genetic changes [3][4][5]. Strategic lesions can result in distinct CSTC loop dysfunctions [6,7]. This work presents two well-studied OCD patients with strategic basal ganglia pathologies which have been classified in vivo.…”

“…In Case 1, the lesion was in the inferior part of the caudate nucleus (ventral striatum adjacent to nucleus accumbens) and the border to the anterior limb of the internal capsule, through which the anterior thalamic radiation out of the medio-dorsal thalamus, the superolateral branch of the medial forebrain bundle, and many frontopontine connections pass. Lesions in the left caudate nucleus have previously been described as associated with OCD [ 6 , 7 ]. The tractography in Patient 2 showed an involvement of the “motor-control network”.…”