In the fall of 2013, a 40-year-old woman in Brazil went under anesthesia for elective plastic surgery: liposuction, an arm lift, breast augmentation, and a tummy tuck. And she got all of that, plus something weirder — an apparently temporary case of kleptomania. Her story was recorded recently in the journal BMJ Case Reports.
After the surgery, the woman woke up drowsy, disoriented, apathetic, and with a clear case of memory loss. In the days that followed the procedure, she began having “recurring, intrusive thoughts and an irresistible compulsion toward stealing,” her physicians write. Her doctors were puzzled: Her condition after the surgery isn’t directly related to kleptomania, and the woman had no prior history of mental-health issues or drug abuse.
They performed an MRI and found a hypoxic-ischaemic injury; a follow-up cerebral perfusion scintigraphy showed a hypoperfusion in the frontal lubes. In plainer English, this means that the woman had suffered a few moments without oxygen while under anesthesia, damaging the caudate nucleus — the part of her brain associated with memory formation and learning. Surgeons think that was a result of deliberate hypotension, a surgical mainstay where doctors decrease a patient’s blood pressure so that there’s less bleeding during surgery. The flip side of deliberate hypotension is that the brain — a high-energy organ — might get “inadequate blood flow,” as case report co-author and surgeon Dr. Fabio Nascimento told Quartz. And that inadequate blood flow — even for a few moments — can be enough to potentially change a person’s brain circuity.
The patient’s next few weeks of recovery were marked with “fairly typical symptoms of kleptomania … an urge to steal followed by a sense of relief after doing so,” Nascimento told LiveScience. Her kleptomaniac episodes lasted only for a couple weeks, but they were enough to get her in legal trouble. She was caught shoplifting, though her doctors defended the woman to police, explaining that the woman’s illegal activity was a result of her temporary psychiatric state of mind.
Lest you worry that you too might have the urge to steal things post-op, take comfort in the fact that cases like this are incredibly rare, with doctors only finding one other case in 2014 of kleptomania that was a result of reduced oxygen to the brain during surgery. In that case, a 55-year-old man suffered from a heart attack that temporarily robbed his brain of oxygen and led to similar kleptomaniac tendencies.
Happily, the patient in the current case study made a complete recovery in a few weeks: As Nascimento explained to LiveScience, her brain healed itself and pieced itself back together by a process of “rewiring” after injury.