aggressive behavior

            Male, 38 year old, alcoholic with agressive behavior in past 2 years. Brain Spect with 99m Tc ECD, shows decreased perfusion in orbitofrontal territory (arrows in saggital slices). In addition marked asymetry in caudate and thalamus with augmented contrast in the left side (arrows in transaxial and coronal slices).

            This indication is less common for brain spect. Several patterns have been described. Amen DG et al comment in a research on 40 patients that they found  decreased activity in the prefrontal cortex, increased activity in the anteromedial portions of the frontal lobes, leftsided increased activity in the basal ganglia and/or limbic system in comparison to the whole brain and focal abnormalities in the left temporal lobe (1).

References:

1   Amen DG, Stubblefield M, Carmicheal B, Thisted R. Brain SPECT findings and aggressiveness. Ann Clin Psychiatry. 1996 Sep;8(3):129-37.

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