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Emotional stroke: clinicoradiologic profile
M Hoffmann1, R Chichkova, A Malek
1Department of Neurology, University of South Florida and Tampa General Hospital, MDC 55, 12901 Bruce B Downs Blvd, Tampa, FL 33612, USA. mhoffman@hsc.usf.edu
Summary
Emotional stressors are linked to stroke, particularly partial anterior circulation strokes with subcortical lesions. While physical deficits are mild, cognitive impairment is frequent in these patients.
Area of Science:
- Neurology
- Psychiatry
- Epidemiology
Background:
- Emotional stressors (ES) are increasingly recognized as potential contributors to cerebrovascular events.
- Understanding the specific stroke subtypes and underlying mechanisms associated with ES is crucial for targeted interventions.
- Previous research has explored various stroke risk factors, but the direct relationship with emotional stressors requires further elucidation.
Purpose of the Study:
- To investigate the association between emotional stressors (ES) and stroke subtypes.
- To identify the common etiologies and lesion topography in patients experiencing stroke with significant ES.
- To evaluate the clinical presentation, including neurological deficit, disability, and cognitive function, in relation to ES.
Main Methods:
- A cohort of 1000 patients with cerebral infarct was assessed for stroke risk factors (RF) and personal/emotional stressors (ES) using the Holmes and Rahe scale.
- Stroke subtypes, etiologies (TOAST classification), lesion topography (MRI), and clinical outcomes (Canadian Neurologic Scale, Rankin scale) were analyzed.
- Statistical comparisons were made between patients with and without significant ES.
Main Results:
- 3.6% of patients (36/1000) reported significant emotional stressors.
- Partial anterior circulation (PAC) infarcts and subcortical lesions were the most frequent topographies in the ES group.
- Cognitive impairment was significantly more prevalent in patients with ES (78% vs. 61%), despite generally mild neurological deficits and minimal disability.
Conclusions:
- Emotional stressors are associated with specific stroke patterns, including partial anterior circulation strokes and subcortical lesions.
- Etiologies for stroke in the presence of ES are frequently unknown or attributed to 'other' causes like coagulopathy or vasculopathy.
- While physical disability is typically mild, neurocognitive deficits are a significant concern in patients experiencing stroke with emotional stressors.