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Case Reports in Psychiatry
Volume 2014, Article ID 741934, 5 pages
http://dx.doi.org/10.1155/2014/741934
Case Report

Bipolar Disorder after Stroke in an Elderly Patient

1Department of Psychiatry, Divino Espírito Santo Hospital, 9500-370 Ponta Delgada, Portugal
2Clinic of Psychiatry and Mental Health, São João Hospital, 4200-319 Porto, Portugal

Received 21 March 2014; Accepted 19 May 2014; Published 4 June 2014

Academic Editor: Liliana Dell’Osso

Copyright © 2014 Raquel Calvão de Melo et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The onset of bipolar disorder (BD) secondary to a stroke event is a rare clinical entity. Although it may be related to specific regions of the brain, several other factors have been linked to its expression such as subcortical atrophy or chronic vascular burden. While precise locations and cerebral circuits involved in the bipolarity expression after stroke still need to be determined, their investigation represents an opportunity to study brain function and BD etiopathogenesis. We present a BD secondary to multiple subcortical biparietal lacunar infarctions, a lacunar infarction in left putamen and an ischemic lesion at the cerebral trunk evolving the right median portion, in a 65-year-old male patient who experienced manic, hypomanic, and depressive episodes, after 6, 10, and 16 months, respectively, of the cerebrovascular events.