Mania after brain injury: Neuroradiological and metabolic findings

Starkstein, Sergio E.; Mayberg, Helen S.; Berthier, Marcelo L.; Fedoroff, Paul; Price, Thomas R.; Dannals, Robert F.; Wagner, Henry N.; Leiguarda, R; Robinson, Robert G.

doi:10.1002/ana.410270612

Cited by 202 publications

(69 citation statements)

References 15 publications

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“…The majority of the studies were case reports (71%) [7,8,17,19,20,21,22,23,24,25,27,28,29,30,32,33,34,35,36,37,38,39,40,41,43,44,45,46,47,48,49,56,57,58,60], followed by case series (14%) [16,18,26,31,51,53,54] and cohort studies (8%) [12,42,52,61]. The fact that case reports are usually shorter descriptions explains the lack of information we found when we tried to assess other parameters of the diagnosis and assessment.…”

Section: Resultsmentioning

confidence: 99%

Mania and Stroke: A Systematic Review

Santos

Caeiro

Ferro³

et al. 2011

Cerebrovasc Dis

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Background: Mania is a rare consequence of stroke and according to the sparse published information it is difficult to describe its demographic, clinical and prognostic characteristics. Methods: We performed a systematic review of all cases of mania and stroke to describe those characteristics. Studies were identified from comprehensive searches of electronic databases, reference lists of the studies collected and handbooks. Two authors independently assessed abstracts, and collected and extracted data. Results: From 265 abstracts, 139 were potentially relevant. For the first analysis, which tries to answer the clinical question of the relationship between mania and stroke, 49 studies met the inclusion criteria and described 74 cases. For the second analysis, we looked for an explicit temporal and causal relationship between manic symptoms and stroke, and selected 32 studies describing 49 cases. In both analyses, the typical patient was male, without a personal or family history of psychiatric disorder, with at least one vascular risk factor, but without subcortical atrophy and had suffered a right cerebral infarct. The majority of patients (92%) presented elevated mood as the first symptom. The other frequent symptoms were an increased rate or amount of speech (71%), insomnia (69%) and agitation (63%). Conclusions: Post-stroke mania should be considered in any manic patient who presents concomitant neurological focal deficits and is older than expected for the onset of primary mania. The results of a systematic study of mania in acute stroke with subsequent follow-up and data from diffusion MR or perfusion CT in a multicenter study with a central database would be relevant.

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Section: Resultsmentioning

confidence: 99%

Mania and Stroke: A Systematic Review

Santos

Caeiro

Ferro³

et al. 2011

Cerebrovasc Dis

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“…In one study the prevalence [4] of postinfarct depression varied from 25% to 50% during the recuperation phase and in another [5] between 18% and 78% in the first two years, reaching its highest point between 3 and 6 months after stroke. Other authors [6,7] observed hypomanic episodes in patients with thalamic lesions of vascular origin in the right hemisphere. Starkstein et al [8] suggested that lesions in the basotemporal lobe and orbitofrontal cortical region lead to a syndrome of disinhibition, secondary to a manic process.…”

Section: Introductionmentioning

confidence: 90%

Affective and Behavioural Dysfunctions in Patients with Subcortical Stroke

Cabello¹,

Gómez-Ruiz²,

Alonso³

et al. 2012

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Objective: To investigate the association of ischaemic and haemorrhagic strokes with the site of subcortical focal cerebrovascular injuries with affective, behavioural and cognitive dysfunctions in the acute phase and after three months. Sample: 58 patients with focal cerebrovascular injuries; mean age 61.5 ± 13.5, 72.4% male. Control group: 20 healthy subjects, mean age 67.1 ± 7.6, 50% male. Results: Significant differences were observed (p = 0.006) between the acute phase and three months later on the apathy items of the Neuropsychiatric Inventory (NPI) in patients with subcortical stroke. Significant differences were also observed on the affective scale of the BRMS (p = 0.004), the behaviour scale of the Maudsley Obsessive-Compulsive Inventory (MOCI) (p = 0.000), and on the Mini Mental State Examination (MMSE) (p = 0.006). No significant differences were observed on the Hamilton Rating Scale-Depression (HRSM) (p = 0.101). Significant differences were found according to the infarct type: patients with haemorrhagic lesions had higher raw scores on the HRS-D than those with ischaemic lesions (p = 0.024). Conclusions: The performance of patients with subcortical stroke on affective, behavioural and cognitive scales improves after three months. Patients with haemorrhagic lesions are more likely to be depressive than those with ischaemic lesions.

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“…A maior parte dos relatos associa-se a lesões no hemisfério direito, incluindo lobos frontais ou temporais, tálamo ou núcleo caudado. Nesse sentido, Starkstein et al 94 observaram hipometabolismo da região temporal inferior direita em três pacientes com mania associada a lesões subcorticais. Os autores sugerem, como mecanismo fisiopatológico, disfunção da alça fronto-estriado-tálamo-cortical interconectada ao sistema límbico e ao lobo temporal, principalmente o direito.…”

Section: Maniaunclassified

Síndromes neuropsiquiátricas associadas a acidentes vasculares encefálicos: revisão de literatura

Pedroso

Souza

Teixeira

2014

J. bras. psiquiatr.

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Objetivo Revisar as principais síndromes neuropsiquiátricas associadas ao acidente vascular encefálico (AVE), suas características clínicas, impacto sobre a recuperação dos pacientes, tratamento, suas possíveis relações com a fisiopatologia dos AVE e, quando possível, contextualizá-las à realidade brasileira. Métodos Foram realizadas buscas nas bases de dados PubMed/MedLine e SciELO/Lilacs com os termos “stroke” e “cerebrovascular disease” em combinações com “neuropsychiatry”, “neuropsychiatric disorders”, “psychiatry”, “psychiatric disorders”, “depression”, “anxiety” e “dementia”, com ênfase nos últimos dez anos. Resultados Foram revisadas as síndromes neuropsiquiátricas pós-AVE, incluindo depressão, ansiedade, transtorno da expressão emocional involuntária, labilidade emocional, irritabilidade, raiva, reação catastrófica, apatia, demência, mania e psicose, de acordo com os objetivos propostos. Conclusão É notória a escassez de informações sobre o manejo terapêutico das complicações neuropsiquiátricas secundárias aos AVE, especialmente diante do impacto em saúde pública representado pelas doenças cerebrovasculares. Com a evolução da abordagem precoce a esses pacientes e o consequente aumento de sua sobrevida, o aprofundamento do conhecimento sobre o desenvolvimento e o tratamento dos transtornos neuropsiquiátricos parece ter maior potencial para melhorar o desfecho e a qualidade de vida dos indivíduos que sofreram AVE.

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Mania after brain injury: Neuroradiological and metabolic findings

Cited by 202 publications

References 15 publications

Mania and Stroke: A Systematic Review

Mania and Stroke: A Systematic Review

Affective and Behavioural Dysfunctions in Patients with Subcortical Stroke

Síndromes neuropsiquiátricas associadas a acidentes vasculares encefálicos: revisão de literatura

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