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A man with onset of obsessive-compulsive disorder(OCD)at age 62 had a large right posterior frontal infarct and occlusion of the ipsilateral internal carotid artery.We review additional cases from the literature with obsessive or compulsive behaviors and structural lesions.OCD may have a structural correlate,and this should be searched for in instances where onset occurs after age 60,is atypical,or is associated with other neurologic signs or symptoms.Rational therapy for OCD will depend on a detailed understanding of the neuronal circuitry and physiologic mechanisms underlying such behaviors,and additional data from thoroughly evaluated patients may be revealing. |
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