917 – Bipolar disorder after stroke in an elderly patient: a case report

Abstract

The onset of Bipolar Disorder secondary to a stroke event is a rare clinical entity, although few cases of isolated post-stroke depression or post-stroke mania have been reported. A 65-year-old male patient without previous psychiatric history presented symptoms of mania, with desinhibition, agitation, insomnia and elevated mood after 6 months of a stroke located to the left side of the brain. The patient was treated efficaciously with mood stabilizers and antipsychotics and his symptoms resolved gradually after 3 months. The patient maintained in remission several months, but then almost a year after the manic episode he presented depressive symptoms indicative to start an antidepressive treatment and the remade of diagnosis to Bipolar Disorder secondary to a stroke. A non-systematic review of PubMed articles since 2000. Numerous emotional and behavioral disorders occur following cerebrovascular lesions. There is higher ‘cerebrovascular risk’ in elderly patients with late onset Bipolar Disorder, compared to those patients with an early onset. This suggests that cerebrovascular risk may be an important factor for the expression of bipolar disorders in later life, and has significant management implications for older bipolar patients.