Psychiatry and Mental Health Department, Centro Hospitalar Universitário Lisboa Norte.
J Nerv Ment Dis. 2021 Nov 1;209(11):851-854. doi: 10.1097/NMD.0000000000001410.
Various diseases that impact different systems and organs in the body may trigger manic episodes. Strokes are often associated with psychiatric symptoms, particularly depressive and, more rarely, manic. We herein report a case of bipolar disorder secondary to cerebrovascular disease in a 67-year-old man with no personal or family history of psychiatric illness who, at the age of 64, had a bilateral ischemic stroke in the middle cerebral artery territory. About 20 days after this stroke, he experienced a manic episode. Three years later, he experienced a second manic episode, with another hospitalization in a psychiatric ward. With this case, we intend to emphasize that, although rare, the diagnosis of mania after stroke should not be forgotten, and most important, one should be aware of the recurrence of affective episodes just as in non-medical-caused bipolar disorder.
各种影响身体不同系统和器官的疾病都可能引发躁狂发作。中风通常与精神症状有关,特别是抑郁,较少见的是躁狂。本文报告了一例 67 岁的男子因脑血管疾病继发的双相情感障碍,该男子无精神疾病的个人或家族史,64 岁时曾发生双侧大脑中动脉区域的缺血性中风。中风后约 20 天,他出现了躁狂发作。3 年后,他经历了第二次躁狂发作,再次住进了精神病病房。通过这个病例,我们想强调的是,尽管罕见,但中风后诊断躁狂不应被遗忘,最重要的是,应像非医学原因引起的双相情感障碍一样,意识到情感发作的复发。