Obsessive-Compulsive Disorder Following Cerebrovascular Accident: A Case Report and Literature Review

Abstract

Background: Cases of obsessive-compulsive disorder (OCD) following cerebrovascular accident (CVA) have rarely been reported.

Methods: Case report and literature review.

Results: We describe the case of a 58-year-old, right-handed man developed OCD 17 months after stroke resulting from lesion of the right middle cerebral artery infarction. The patient was successfully treated with sertraline up to 50 mg per day. His OCD behaviors largely reduced in 6 weeks, and the Yale-Brown Obsessive Compulsive Scale score was reduced from 29 to 12 in 1 year. A literature review revealed 21 previous cases of OCD following CVA. Among these, consistent with our case, the basal ganglia was the most common site of the lesion responsible for the development of this rare disorder. We discuss the patient's treatment and outcomes.

Conclusions: Our present case and a literature review suggest that OCD can manifest following CVA, although further studies are necessary. Selective serotonin reuptake inhibitors appear to be effective in treating this rare disorder.

Keywords: Obsessive-compulsive disorder; basal ganglia; cerebrovascular accident; sertraline; stroke.