Mood Disorders Secondary to Stroke

Mood disorders associated with stroke have been recognized by clinicians for over 100 years. Recent studies, however, have begun to distinguish whether these mood disorders represent primary disorders or are a secondary consequence of the cerebral infarction. Although poststroke mood disorders share similarities with primary mood disorders in their clinical phenomenology, longitudinal course, and response to treatment, clinical-pathologic correlations during the acute poststroke period have provided a strong argument that these disorders are frequently etiologically linked to the cerebral ischemia. Major depression during the acute stroke period was associated with left frontal and left basal ganglia lesions, while mania was associated with right orbital frontal, basotemporal, basal ganglia, or thalamic lesions. Identification of the mechanism of these disorders will ultimately establish their "secondariness" as well as development of more focused treament strategies.