Safe Administration of ECT in a Suicidal Patient with a Space-Occupying Astrocytoma

Nagy A. Youssef, Benjamin Casola, Peter B. Rosenquist, William V. McCall, Vanessa Spearman

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Electroconvulsive therapy (ECT) can be lifesaving for patients suffering from treatment-resistant psychiatric conditions, especially acute suicidality or depression. However, space-occupying lesions pose risks associated with ECT use due in part to seizure-induced escalations in blood pressure with corresponding increases in cerebral blood flow and possibly intracranial pressure, subsequently increasing the risk of brain herniation. Here, we present the case of a patient with a left medial temporal lobe astrocytoma, worsening epileptic seizures, and nonepileptic seizures who underwent ECT for major depressive disorder and suicidality. The patient had improvement of depressive symptoms, resolution of suicidality, and brief cessation of nonepileptic seizures. Brief anterograde amnesia contributed to the termination of treatment. This case adds to the growing literature about the feasibility of ECT treatment in cerebral lesions prone to changes in intracranial pressure, such as the usually cystic astrocytomas.

Original languageEnglish (US)
Pages (from-to)207-208
Number of pages2
JournalThe journal of ECT
Issue number3
Early online dateFeb 19 2021
StatePublished - 2021


  • astrocytoma
  • ECT
  • intracranial masses
  • MDD
  • suicidality

ASJC Scopus subject areas

  • Neuroscience (miscellaneous)
  • Psychiatry and Mental health


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