Basal ganglial hemorrhage induced mania

Neuroimaging studies on mood disorders concentrate on the limbic system, especially on the hippocampus and amygdala. Accumulating evidence suggests an association between abnormalities of the basal ganglia and mood disorders. We present a case of mania following basal ganglial hemorrhage. A 30-year old male, with no history of bipolar disorder, was admitted to the emergency room with complaints of euphoria and decreased need for sleep. During psychiatric assessment, he exhibited grandiosity, psychomotor activation, irritability, and şight of ideas. The patient,whose cranial MRI showed hemorrhage in the basal ganglia, was hospitalized with a diagnosis of mood disorder due to a general medical condition. Lorazepam 5mg/day and olanzapine 10mg/day was started. On the tenth day of treatment his episode ended. The basal ganglia are interconnected with the limbic system and prefrontal cortex and therefore are implicated in bipolar disorder.