Porencephaly and psychosis: a case report and review of the literature

Abstract

Background: Malformations of the cerebral cortex are often associated with developmental delay and psychoses. Porencephaly is a rare congenital disorder of central nervous system involving a cyst or a cavity filled with cerebrospinal fluid, in brain's parenchyma.

Case presentation: We present a 25 years old woman with her first psychotic episode. She also suffers from porencephaly in the frontotemporal lobes region. It is emphasized that the two consistently abnormal brain regions in schizophrenia research had significant damage in this patient since birth. There is a total of only five cases of schizencephaly or porencephaly associated with psychosis in the scientific literature. Their clinical characteristics as well as the imaging results are described.

Conclusion: It is unclear if porencephaly and psychosis concur by chance or are causally related. The area where the porencephalic cysts appear seems to be of relevance. This case highlights the need for further research.

Figure 1

Coronal T1 Large area of porencephaly in the left frontal and parietal lobes, in the anatomic distribution of left middle cerebral artery branches. Wallerian degeneration of the ipsilateral cerebral peduncle was also present (not shown).

Figure 2

Axial T2 Large area of porencephaly in the left frontal and parietal lobes with compensatory dilatation of the lateral ventricle.