[Mental disorders due to lacunar infarcts. Two case reports]

Lacunar infarcts have a high prevalence, about 10%, mainly in the elderly. Although the most frequent feature are the lacunar syndromes as a neurologic form, psychiatrist should bear them in mind because it is possible the presence of psychiatric symptoms as the only manifestation of them. We report two examples of it. The first case in a man with a transitory episode of uninhibition, with maniform characteristics, and frontal disturbance signs. The second one is a woman with a peduncular ballucinosis. The only neuroradiological finding were lacunar infarcts in both of them. We discuss a pathogenic hypothesis to explain these features. The first case may be a disconnection of the system that integrates the basal ganglia, thalamus and thalamocortical projections; the second one can be originated because of interruptions of the nigroestriatal connections.