Poststroke Bipolar Disorder

Abstract

Various diseases that impact different systems and organs in the body may trigger manic episodes. Strokes are often associated with psychiatric symptoms, particularly depressive and, more rarely, manic. We herein report a case of bipolar disorder secondary to cerebrovascular disease in a 67-year-old man with no personal or family history of psychiatric illness who, at the age of 64, had a bilateral ischemic stroke in the middle cerebral artery territory. About 20 days after this stroke, he experienced a manic episode. Three years later, he experienced a second manic episode, with another hospitalization in a psychiatric ward. With this case, we intend to emphasize that, although rare, the diagnosis of mania after stroke should not be forgotten, and most important, one should be aware of the recurrence of affective episodes just as in non-medical-caused bipolar disorder.

Poststroke Mania During the COVID-19 Pandemic

“…Poststroke mania is often temporary, so prophylactic antimanic drugs are not needed after remission. However, there is also a report that a second manic state occurred 3 years after the remission of poststroke mania (Saraiva et al, 2021). Considering recurrence several years later, careful follow-up is necessary.…”

“…Strokes are often associated with psychiatric symptoms, particularly depressive and, more rarely, manic symptoms (Saraiva et al 2021). Delirium, pseudobulbar affect (PBA), and mania should be considered as differential diagnoses of poststroke agitation.…”