Neurosurgical Review

, Volume 33, Issue 1, pp 107–114 | Cite as

Hypersexuality from resection of left occipital arteriovenous malformation

  • Yong Cao
  • Zhaohui Zhu
  • Rong Wang
  • Shuo Wang
  • Jizong Zhao
Case Report


The authors report their experience on one patient with hypersexuality from resection of left occipital arteriovenous malformation. To the best of our knowledge, this is the first case reported in the literature. A 35-year-old right-handed female farmer suffered a sudden left occipital hemorrhage with subarachnoid and subdural hemorrhages of the left hemisphere. Transient left uncal herniation occurred at the onset and was released by conservative treatment. Digital subtraction angiography showed a brain left occipital arteriovenous malformation. After microsurgical resection of the arteriovenous malformation, the patient developed hypersexual behavior. Positron emission tomography showed hypermetabolism in the left frontal region and left posterior hippocampal gyrus and hypometabolism in the left anterior hippocampal gyrus and the left occipital surgical area. Theories concerning normal pressure perfusion breakthrough and specific areas in the brain responsible for the human sexual response are discussed.


Arteriovenous malformation Hypersexuality Normal pressure perfusion breakthrough Positron emission tomography 


  1. 1.
    Anonymous (1999) Arteriovenous malformations in the brain in adults. N Engl J Med 340:1812–1818CrossRefGoogle Scholar
  2. 2.
    Baker RP, McCarter RJ, Porter DG (2004) Improvement in cognitive function after right temporal arteriovenous malformation excision. Br J Neurosurg 18(5):541–544CrossRefPubMedGoogle Scholar
  3. 3.
    Batjer HH, Devous MD, Meyer YJ, Purdy PD, Samson DS (1988) Cerebrovascular hemodynamics in arteriovenous malformation complicated by normal perfusion pressure breakthrough. Neurosurgery 22:503–9PubMedCrossRefGoogle Scholar
  4. 4.
    Benjamin S, Kirsch D, Visscher T, Ozbayrak KR, Weaver JP (2000) Hypomania from left frontal AVM resection. Neurology 54(6):1389–1390PubMedGoogle Scholar
  5. 5.
    Boller F, Frank E (1982) Clinical syndromes. In: Boller F, Frank E (eds) Sexual dysfunction in neurological disorders. Diagnosis, management and rehabilitation. Raven, New York, pp 48–50Google Scholar
  6. 6.
    Braun CMJ, Dumont M, Duval J, Hamel I, Godbout L (2003) Opposed left and right brain hemisphere contributions to sexual drive: a multiple lesion case analysis. Behav Neurol 14(1–2):55–61PubMedGoogle Scholar
  7. 7.
    Chyatte D (1997) Normal pressure perfusion breakthrough after resection of arteriovenous malformation. J Stroke Cerebrovasc Dis 6(3):130–136CrossRefPubMedGoogle Scholar
  8. 8.
    Gondim FA, Thomas FP (2001) Episodic hyperlibidinism in multiple sclerosis. Mult Scler 7(1):67–70PubMedGoogle Scholar
  9. 9.
    Goscinski I, Kwiatkowski S, Polak J, Orlowiejska M, Partyk A (1997) The Kluver–Bucy syndrome. J Neurosurg Sci 41(3):269–272PubMedGoogle Scholar
  10. 10.
    Mahalick DM, Ruff RM, Heary RF, U HS (1993) Preoperative versus postoperative neuropsychological sequelae of arteriovenous malformations. Neurosurgery 33(4):563–570CrossRefPubMedGoogle Scholar
  11. 11.
    Miller BL, Cummings JL, McIntyre H, Ebers G, Grode M (1986) Hypersexuality or altered sexual preference following brain injury. J Neurol Neurosurg Psychiatry 49(8):867–873CrossRefPubMedGoogle Scholar
  12. 12.
    Nagaratnam N, Gayagay G Jr (2002) Hypersexuality in nursing care facilities—a descriptive study. Arch Gerontol Geriatr 35(3):195–203CrossRefPubMedGoogle Scholar
  13. 13.
    Roane DM, Yu M, Feinberg TE, Rogers JD (2002) Hypersexuality after pallidal surgery in Parkinson disease. Neuropsychiatry Neuropsychol Behav Neurol 15(4):247–251PubMedGoogle Scholar
  14. 14.
    Romito LM, Raja M, Daniele A, Contarino MF, Bentivoglio AR, Barbier A, Scerrati M, Albanese A (2002) Transient mania with hypersexuality after surgery for high frequency stimulation of the subthalamic nucleus in Parkinson’s disease. Mov Disord 17(6):1371–1374CrossRefPubMedGoogle Scholar
  15. 15.
    Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, Ferguson D, D’Agostino R Jr (2000) The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 26:191–208CrossRefPubMedGoogle Scholar
  16. 16.
    Sandel ME, Williams KS, Dellapietra L, Derogatis LR (1996) Sexual functioning following traumatic brain injury. Brain Inj 10(10):719–728CrossRefPubMedGoogle Scholar
  17. 17.
    Stabell KE, Nornes H (1994) Prospective neuropsychological investigation of patients with supratentorial arteriovenous malformations. Acta Neurochir (Wien) 131(1–2):32–44CrossRefGoogle Scholar
  18. 18.
    Stein DJ, Hugo F, Oosthuizen P, Hawkridge SM, van Heerden B (2000) Neuropsychiatry of hypersexuality. CNS Spectr 5(1):36–46PubMedGoogle Scholar
  19. 19.
    Zencius A, Wesolowski MD, Burke WH, Hough S (1990) Managing hypersexual disorders in brain-injured clients. Brain Inj 4(2):175–181CrossRefPubMedGoogle Scholar
  20. 20.
    Zhao J, Wang S, Li J, Qi W, Sui D, Zhao Y (2005) Clinical characteristics and surgical results of patients with cerebral arteriovenous malformations. Surg Neurol 63(2):156–61CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Yong Cao
    • 1
  • Zhaohui Zhu
    • 2
  • Rong Wang
    • 1
  • Shuo Wang
    • 1
  • Jizong Zhao
    • 1
  1. 1.Department of NeurosurgeryBeijing Tiantan Hospital, affiliated to Capital Medical UniversityBeijingChina
  2. 2.PET CenterPeking Union Medical College HospitalBeijingChina

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