Long-term Results of Stereotactic Radiofrequency Surgery for Aggressive Behavioral in Obsessive-Compulsive Adolescent – A 10-Year Follow-up Case Report
DOI:
https://doi.org/10.46900/apn.v8i2.324Keywords:
Aggressive behavior, Radiofrequency, Obsessive-compulsive disorder, Stereotactic ablationAbstract
Introduction: Aggressive and self-injurious behaviors associated with obsessive-compulsive disorder in patients with intellectual disability represent a major therapeutic challenge, particularly in cases refractory to pharmacological and behavioral treatment. In this context, stereotactic neurosurgery has been considered a last-resort option, targeting limbic and paralimbic circuits involved in emotional and behavioral regulation.
Case Report: We report the case of a 17-year-old male with pharmacological resistant obsessive-compulsive disorder and severe mental retardation, with a 9-year history of refractory aggressive behavior, who underwent stereotactic neurosurgical intervention in 2006. Preoperatively, the patient exhibited high levels of aggression (MOAS score: 31). Postoperatively, there was a complete and sustained remission of aggressive episodes, with MOAS scores of 0 at all follow-up intervals up to 10 years. The patient also experienced marked improvement in obsessive-compulsive symptoms, reduction in psychotropic medications, and significant enhancement in attention, concentration, quality of life, and family satisfaction. One wound infection was reported postoperatively, with no lasting adverse effects.
Conclusion: This case highlights the potential for stereotactic lesioning to induce profound and durable behavioral improvements in select patients with treatment-refractory aggression.
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Copyright (c) 2026 Walter Fagundes, Rodolpho Albuquerque Souza, Ricardo Santos de Oliveira, Sergio Dantas
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