Saturday, July 19, 2008

Compulsive Collecting of Toy Bullets


Figure 1 (Hahm et al., 2001). A sample bottle containing the toy bullets collected by the patient.

ResearchBlogging.org

A previously healthy 46 year old man experienced a ruptured aneurysm of the anterior communicating artery, resulting in extensive damage to the left orbitofrontal cortex and caudate nucleus (Hahm et al., 2001). He underwent surgical procedures to remove the aneurysm and to shunt the buildup of excessive CSF, which was causing hydrocephalus. Two months later, he recovered his health but showed residual memory deficits and a number of behavioral changes, foremost among which was a newly-developed compulsion to collect an unusual item (and only that item).
The most interesting behavior began in July 1997 during his first walk in a park since his illness; his wife witnessed him picking up bullets of a toy gun from the ground. Thereafter, whenever he went outside, he walked with his gaze downward in search of these bullets. The plastic bullet was round and small (5 mm in diameter) (figure 1) and would be very challenging for most individuals to find in public. Nevertheless, he has collected over 5,000 bullets in the ensuing 2 years and kept them in bottles at home.


from Figure 2 (Hahm et al., 2001). CT scan on admission shows subarachnoid hemorrhage with a hematoma involving left orbitofrontal region.

At home with his wife, he would not seek the objects. When left alone, however, he would wander the streets for hours, collecting bullets even in foul weather. Although his collecting behavior embarrassed his wife, he was unconcerned about the thoughts of others. He never collected other items besides the toy bullets.
Other papers (e.g., Anderson et al., 2005) have reported on the emergence of obsessive-compulsive, collecting, or hoarding behaviors following damage to the orbitofrontal region, but this is the first case of compulsive collecting of toy bullets.

References

Anderson SW, Damasio H, Damasio AR. (2005). A neural basis for collecting behaviour in humans. Brain 128:201-12.

Hahm DS, Kang Y, Cheong SS, Na DL. (2001). A compulsive collecting behavior following an A-com aneurysm rupture. Neurology, 56(3), 398-400.

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