Crown of Tyranny

The Crown of Tyranny is a helmet that belonged to the dreadlord Balnazzar.

The helmet can be useful on the battlefield, as it improves the accuracy and response of its wearer, but rumor has it that those who wear it end up being driven insane by dreams of the Twisting Nether.

Source
This item drops from Balnazzar in the Stratholme Main Gate wing.