The Journal of neuropsychiatry and clinical neurosciences
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J Neuropsychiatry Clin Neurosci · Jan 1990
Case ReportsSecondary mania after ventral pontine infarction.
Secondary mania is increasingly recognized clinically, and consists of acute exhibition of manic symptoms without past or family history of affective disorder. It has been reported with toxic and metabolic disturbances, primary and metastatic brain tumors, epilepsy, and cerebrovascular events. A multifactorial etiology has been suggested. ⋯ Magnetic resonance studies demonstrated infarction of the ventral pons (on the right in the patient with left-sided signs and on the left in the patient with normal neurologic examination). The two patients responded to lithium carbonate and neuroleptics and have not had further psychiatric symptoms in 18 months of follow-up. These cases emphasize the relationship of late-onset mania with predisposing brain disease, and they suggest that brainstem disturbances can influence mood, sleep, libido, and thought.
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J Neuropsychiatry Clin Neurosci · Jan 1990
ReviewCurrent research in affective disorders following stroke.
The prevalence, diagnosis, clinical presentation, evolution, and treatment of depression and mania following stroke are discussed. Among the many studies presented in the review is one that indicates major depression following right hemisphere lesions is associated with a positive family history of psychiatric disorder and lesions involving the parietal cortex. ⋯ A recent study has also shown a strong association between mania and direct or indirect dysfunction of the basotemporal cortex in the right hemisphere. Possible mechanisms for both mania and depression following stroke are presented, and ideas for future directions in research are suggested.