Soon after treatment of a right basotemporal vascular malformation using
an embolization procedure, a 25-year-old patient developed an acute episode
of mania. Two months later the patient was still manic, and a second
embolization was scheduled. Before it was conducted, a Wada test was
carried out to determine speech dominance. No changes in manic symptoms
were observed after amytal injections into the left middle cerebral, right
frontopolar, or right middle cerebral arteries. This finding suggests that
secondary mania may not be the result of "release" of the left hemisphere
following a right hemisphere lesion but instead may be related to specific
disturbances within the right hemisphere.Abstract Teaser