Affiliations: Department of Physical Medicine & Rehabilitation,
Johns Hopkins School of Medicine, Baltimore, MD, USA | Department of Psychiatry, Johns Hopkins School of
Medicine, Baltimore, MD, USA | Kennedy Krieger Institute, Baltimore, MD, USA | Division of Pediatric Neurosurgery, Johns Hopkins
School of Medicine, Baltimore, MD, USA
Note: [] Corresponding author: Frank S. Pidcock, MD, Department of
Physical Medicine & Rehabilitation, Johns Hopkins School of Medicine, 707
North Broadway, Baltimore, MD 21205, USA. Tel.: +1 443 923 9440; Fax: +1 443
923 9445; E-mail: pidcock@kennedykrieger.org
Abstract: This report describes a patient who developed agitation,
disorientation, visual hallucinations, inappropriate verbal outbursts, and
impaired memory following resection of a choroid plexus papilloma. No medical,
neurologic, or metabolic disorders unrelated to the surgery were identified.
Five weeks following surgery, treatment with aripiprazole, a partial dopamine
agonist, was started to address the delirious state. Improvements in agitation,
orientation, memory, and executive functions, as well as a decrease in
emotional lability, began within twenty-four hours and continued over the
remainder of the inpatient hospitalization. Five months after initial
resection, aripiprazole was discontinued without worsening of cognitive or
emotional functions. Persistent difficulties with working memory, planning,
judgment, and visuospatial skills were noted on neuropsychological examination
six months following tumor removal. This case illustrated the therapeutic
benefit of aripiprazole for treatment of mental status changes associated with
resection of a posterior fossa tumor.
