Combined frontal cavernoma and developmental venous angioma presenting as organic personality disorder: a case report.

BACKGROUND

Organic personality disorder is a - nowadays - rare and often overlooked diagnosis characterized by persistent personality changes resulting from a direct physiological effect of a medical condition. CASE PRESENTATION: This case report presents a middle-aged male patient who was initially misdiagnosed with bipolar disorder despite longstanding neuropsychiatric symptoms, poor treatment response, and progressive functional decline. The patient exhibited impulsivity, disinhibition, cognitive deficits, and aggressive behaviour, culminating in a suicide attempt. Neuroimaging revealed a right frontal cavernoma with associated developmental venous angioma, and neuropsychological testing confirmed frontal lobe dysfunction. The diagnosis of organic personality disorder with combined specifiers—aggression, disinhibition, and affective lability—was ultimately made. DISCUSSION AND

CONCLUSION

This case underscores the clinical importance of recognizing organic contributions to personality disturbances, especially when conventional psychiatric treatments fail. It highlights the necessity for comprehensive neuropsychiatric assessment, careful diagnostic differentiation, and the integration of radiological findings in formulating accurate diagnoses. CLINICAL TRIAL NUMBER: Not applicable.