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[Mental disorders due to lacunar infarcts. Two case reports]
E Hortega de Frutos1, I García Cabeza, M González de Chávez
1Departamento de Psiquiatría, Hospital General Universitario Gregorio Marañón, Madrid.
Actas Luso-Espanolas De Neurologia, Psiquiatria Y Ciencias Afines
|July 1, 1997
Summary
Lacunar infarcts, common in the elderly, can manifest solely as psychiatric symptoms. Recognizing these subtle signs is crucial for accurate diagnosis and treatment of lacunar stroke.
Area of Science:
- Neurology
- Psychiatry
Background:
- Lacunar infarcts are prevalent, particularly in the elderly population.
- While often presenting with neurological deficits, lacunar infarcts can also manifest with psychiatric symptoms.
Observation:
- Two cases are presented where lacunar infarcts were the sole neuroradiological finding.
- The first case involved a man with transient disinhibition and frontal signs, resembling mania.
- The second case featured a woman with peduncular hallucinations.
Findings:
- These cases highlight that psychiatric symptoms can be the only presenting feature of lacunar infarcts.
- The study discusses potential pathogenic mechanisms, including disconnection in basal ganglia-thalamocortical pathways and interruption of nigrostriatal connections.
Implications:
- Psychiatrists should consider lacunar infarcts in the differential diagnosis of unexplained psychiatric presentations.
- Early recognition of lacunar infarcts, even without overt neurological signs, is vital for appropriate management and to prevent further cerebrovascular events.