BACKGROUND: Atypical presentation of psychiatric symptoms can lead to a variety of misdiagnoses. Organic causes, including brain tumors, should be considered under these circumstances. METHODS: We present a case report of an 84-year-old woman with irritable, aggressive, and delusional behavior. Her earlier diagnoses included altered mental status, encephalopathy, dementia, nonspecified psychosis, and delirium with delusions. We suspected that a brain tumor could be causing her psychiatric symptoms. RESULTS: CT of the head revealed 2 calcified meningiomas, which did not require surgery. Neuropsychological testing results were consistent with frontal lesion type of cognitive and psychotic symptoms. Psychiatric symptoms improved with risperidone. A brief review of the literature is included. CONCLUSIONS: Brain imaging should be considered in cases of atypical psychiatric presentations. Past medical records and neuropsychological testing could assist in the diagnosis.
BACKGROUND: Atypical presentation of psychiatric symptoms can lead to a variety of misdiagnoses. Organic causes, including brain tumors, should be considered under these circumstances. METHODS: We present a case report of an 84-year-old woman with irritable, aggressive, and delusional behavior. Her earlier diagnoses included altered mental status, encephalopathy, dementia, nonspecified psychosis, and delirium with delusions. We suspected that a brain tumor could be causing her psychiatric symptoms. RESULTS: CT of the head revealed 2 calcified meningiomas, which did not require surgery. Neuropsychological testing results were consistent with frontal lesion type of cognitive and psychotic symptoms. Psychiatric symptoms improved with risperidone. A brief review of the literature is included. CONCLUSIONS: Brain imaging should be considered in cases of atypical psychiatric presentations. Past medical records and neuropsychological testing could assist in the diagnosis.