Institute of Molecular Medicine, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.
Cerebrovasc Dis. 2011;32(1):11-21. doi: 10.1159/000327032. Epub 2011 May 11.
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.
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.
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%).
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.
躁狂是中风的罕见后果，根据发表的有限信息，难以描述其人口统计学、临床和预后特征。
我们对所有躁狂和中风的病例进行了系统回顾，以描述这些特征。通过全面搜索电子数据库、收集的研究参考文献和手册，确定了研究。两位作者独立评估摘要，并收集和提取数据。
从 265 篇摘要中，有 139 篇可能相关。为了首次分析，试图回答躁狂与中风之间的临床关系问题，有 49 项研究符合纳入标准，描述了 74 例病例。为了第二次分析，我们寻找躁狂症状与中风之间明确的时间和因果关系，并选择了 32 项研究，描述了 49 例病例。在这两种分析中，典型患者为男性，无精神障碍个人或家族史，至少有一个血管危险因素，但无皮质下萎缩，并发生右侧脑梗死。大多数患者（92%）以情绪升高为首发症状。其他常见症状包括言语速度或量增加（71%）、失眠（69%）和激越（63%）。
在出现伴随神经局灶性缺损且发病年龄超过原发性躁狂预期的任何躁狂患者中，都应考虑中风后躁狂。对急性中风后伴有后续随访的躁狂进行系统研究的结果，以及来自多中心研究中心数据库的弥散 MR 或灌注 CT 数据将是相关的。
