Stroke-psychosis. Description of two cases

Abstract

Introduction. The presence of neuropsychiatry symptoms (hallucinations, delusions and agitation) as stroke-related guideline symptoms, thus forming an acute psychosis of organic cause, are extremely uncommon and often correlate with strategic infarcts (caudate nucleus, striatum and thalamus).

Clinical case. We report two cases of stroke-psychosis. Case 1: a 67-year-old man with sudden-onset delusions of persecution and complete recovery in three months. The brain magnetic resonance imaging (MRI) revealed infarctions in both head of the caudate nucleus and body of right caudate nucleus. Case 2: a 49-year-old man with sudden-onset delusions of persecution and gustative hallucinations that disappeared in three months. The brain MRI revealed small infarction in the left thalamus.

Discussion. The possible vascular origin of the psychosis in both cases (sudden onset, complete recover, demonstration of acute ischemic lesion in strategic territory) and the underlying psychopathogenic mechanism (dysfunction of prefrontal cortico-subcortical circuits) is discussed.