Das Piyush, Chopra Amit, Rai Abhishek, Kuppuswamy Preetha Sharone
Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, MN, USA.
Mental Health Clinic, VA Medical Center, Grand Island, USA.
Bipolar Disord. 2015 Sep;17(6):677-82. doi: 10.1111/bdi.12318. Epub 2015 Aug 8.
The aim of the present case report was to describe the late onset of recurrent mania in a patient after ischemic injury to the cerebellum and dorsolateral medulla.
We studied an 86-year-old male with no prior psychiatric history who developed recurrent episodes of mania following a brain stroke. Additionally, he had neurological symptom constellation typical of Wallenberg syndrome.
Magnetic resonance imaging of the brain revealed infarction in the inferomedial right cerebellar hemisphere and the right dorsolateral medulla in the right posterior inferior cerebellar artery (PICA) distribution. He was successfully managed with a combination of antipsychotic and mood-stabilizer medications.
Post-stroke mania may be one of the rare manifestations of Wallenberg syndrome. This case adds to the emerging literature on cerebellar involvement in mood regulation and pathology of mania.
本病例报告旨在描述一名小脑和延髓背外侧缺血性损伤后迟发性复发性躁狂症患者的情况。
我们研究了一名86岁男性，他既往无精神病史，在脑卒中后出现复发性躁狂发作。此外，他具有典型的延髓背外侧综合征神经症状群。
脑部磁共振成像显示右小脑半球下内侧和右后下小脑动脉（PICA）分布区的右延髓背外侧梗死。通过抗精神病药物和心境稳定剂联合治疗，他的病情得到了成功控制。
卒中后躁狂可能是延髓背外侧综合征的罕见表现之一。该病例为有关小脑参与情绪调节和躁狂症病理学的新文献增添了内容。
