Okamoto Naomichi, Ikenouchi Atsuko, Seki Issei, Hirano Natsumi, Yoshimura Reiji
Medical Center for Dementia, University Hospital/Psychiatry, University of Occupational and Environmental Health, Kitakyushu, JPN.
Psychiatry, University of Occupational and Environmental Health, Kitakyushu, JPN.
Cureus. 2021 Jul 15;13(7):e16411. doi: 10.7759/cureus.16411. eCollection 2021 Jul.
Cerebral amyloid angiopathy (CAA) is a major cause of spontaneous intracerebral hemorrhage in the elderly. There are no reports of CAA causing mania or hypomanic episodes, and the incidence of mania or hypomanic episodes in patients with vascular dementia is generally considered to be rare. Here, we present a case of CAA with hypomania in which valproic acid (VPA) led to improvement in the symptoms of hypomania. An 80-year-old, right-handed Japanese woman with mild cognitive impairment (MCI) presented with a hypomanic episode. Her brain magnetic resonance imaging showed multiple obsolete infarcts and hemorrhages caused by CAA. We diagnosed her as suffering from a hypomanic episode in MCI associated with CAA and started VPA 400 mg/day for seven weeks. Her hypomanic episode gradually improved on VPA. This case indicates that VPA can be useful in the treatment of hypomanic episodes in MCI associated with CAA.
脑淀粉样血管病（CAA）是老年人自发性脑出血的主要原因。尚无CAA导致躁狂或轻躁狂发作的报道，血管性痴呆患者中躁狂或轻躁狂发作的发生率通常被认为很低。在此，我们报告1例CAA伴轻躁狂发作的病例，丙戊酸（VPA）使轻躁狂症状得到改善。1名80岁右利手日本女性，有轻度认知障碍（MCI），出现轻躁狂发作。其脑部磁共振成像显示由CAA引起的多发陈旧性梗死和出血。我们诊断她患有与CAA相关的MCI伴轻躁狂发作，并开始每天服用400 mg VPA，持续7周。在VPA治疗下，她的轻躁狂发作逐渐改善。该病例表明，VPA可有效治疗与CAA相关的MCI中的轻躁狂发作。
