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Left frontotemporal hyperperfusion in a patient with post-stroke mania.

Masaru Mimura1, Kazuyuki Nakagome, Natsuko Hirashima

  • 1Department of Neuropsychiatry, Showa University School of Medicine, 1-5-8 Hatanodai, Tokyo 142-8666, Japan. mimura@med.showa-u.ac.jp

Psychiatry Research
|August 2, 2005
PubMed
Summary

A stroke in a 78-year-old woman with depression led to acute mania. Brain imaging revealed altered blood flow in the orbitofrontal cortex, suggesting a role in post-stroke mania.

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Area of Science:

  • Neuroscience
  • Neurology
  • Psychiatry

Background:

  • Major depression is a common psychiatric disorder.
  • Stroke can lead to various neurological and psychiatric complications.
  • Orbitofrontal cortex plays a role in mood regulation and executive functions.

Observation:

  • A 78-year-old female patient with a history of major depression experienced a right middle cerebral artery infarction.
  • Following the stroke, the patient developed acute mania.
  • Pre- and post-stroke single-photon emission computed tomography (SPECT) scans were compared.

Findings:

  • SPECT scans revealed a unique pattern of left orbitofrontal hyperperfusion and extensive right frontal hypoperfusion post-stroke.
  • This asymmetrical perfusion pattern suggests a functional imbalance between the right and left orbitofrontal cortices.

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Implications:

  • The findings suggest that a functional imbalance in the orbitofrontal cortex may be a key factor in the development of acute post-stroke mania.
  • This case highlights the complex relationship between cerebrovascular events, mood disorders, and specific brain regions.
  • Further research into orbitofrontal cortex function in mania is warranted.