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Self-reported aggressive behavior in patients with stroke

S Paradiso1, R G Robinson, S Arndt

  • 1Department of Psychiatry, University of Iowa Hospitals and Clinics, Iowa City 52242, USA.

The Journal of Nervous and Mental Disease
|December 1, 1996
PubMed
Summary
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Patients experiencing violent outbursts after a stroke often have greater cognitive impairment and left anterior hemisphere lesions. These factors, along with lesion proximity to the frontal pole, are linked to increased anger and aggression post-stroke.

Area of Science:

  • Neuroscience
  • Neurology
  • Psychiatry

Background:

  • Violent outbursts and anger are observed in patients following a stroke (cerebrovascular accident).
  • Understanding the clinical and neuropathological factors associated with these behaviors is crucial for patient care.

Purpose of the Study:

  • To identify clinical and pathoanatomical correlates of violent outbursts in patients with cerebrovascular accident.
  • To investigate the relationship between lesion location, cognitive status, depression, and aggressive behavior after stroke.

Main Methods:

  • Compared patients reporting violent outbursts post-stroke with matched controls.
  • Utilized structured interviews, Present State Exam, and Hamilton Depression Rating Scale.
  • Analyzed lesion location (hemisphere, proximity to frontal pole) and cognitive impairment.

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Main Results:

  • Patients with violent outbursts showed higher cognitive impairment (66% vs 22%) and a higher frequency of left-hemisphere lesions (46.7% vs 29.4%).
  • Lesion proximity to the frontal pole was associated with irritable/violent behavior.
  • The association between left anterior lesions, cognitive impairment, and violence persisted even after accounting for depression.

Conclusions:

  • Violent outbursts in stroke patients have multiple clinical and neuropathological correlates.
  • Greater cognitive impairment and left anterior hemisphere lesions are significant factors.
  • These findings highlight the complex interplay of brain injury and behavioral changes after stroke.