Document Detail

Aggressive behavior and posterior cerebral artery stroke.
MedLine Citation:
PMID:  17620495     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To describe the mechanisms leading to aggressive behavior among patients with acute posterior cerebral artery stroke. DESIGN, SETTING, AND PATIENTS: We prospectively included all of the patients with posterior cerebral artery stroke and aggressive behavior admitted to our department from January 1, 2003, to December 31, 2004. Patients with history of stroke, cognitive impairment, or prior history of psychiatric disease were excluded. RESULTS: Aggressive behavior was found in 3 patients (7.3%) among 41 patients with posterior cerebral artery stroke. One patient had right occipitotemporal and ventrolateral thalamic stroke. The second patient had left occipitotemporal and lateral thalamic stroke. The third patient had right isolated occipital stroke. In addition to a contralateral homonymous hemianopsia, the patients, who were physically and emotionally balanced before the stroke, suddenly manifested an acute, unusual, aggressive behavior. The patients became agitated and aggressive when they were stimulated by the environment, and they responded to solicitation by their relatives or medical personnel by shouting obscenities and hitting and biting others. In all of the 3 cases, temporary physical restraint was required and neuroleptics were administered. This unusual behavioral pattern resolved within 2 weeks after stroke. CONCLUSIONS: Aggressive behavior is a rare presentation of acute posterior cerebral artery stroke, which may be difficult to diagnose in patients presenting with hemianopsia as the only concomitant neurological sign. The postulated mechanisms include dysfunction of the limbic or serotoninergic system.
Stephan A Botez; Emmanuel Carrera; Philippe Maeder; Julien Bogousslavsky
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Archives of neurology     Volume:  64     ISSN:  0003-9942     ISO Abbreviation:  Arch. Neurol.     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-07-10     Completed Date:  2007-08-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372436     Medline TA:  Arch Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1029-33     Citation Subset:  AIM; IM    
Department of Neurology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
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MeSH Terms
Aged, 80 and over
Aggression / physiology*
Antipsychotic Agents / therapeutic use
Brain / blood supply,  pathology*,  physiopathology
Disease Progression
Functional Laterality / physiology
Hemianopsia / etiology,  pathology,  physiopathology
Infarction, Posterior Cerebral Artery / complications*,  pathology*,  physiopathology
Limbic System / blood supply,  pathology,  physiopathology
Mental Disorders / etiology*,  pathology*,  physiopathology
Occipital Lobe / blood supply,  pathology,  physiopathology
Posterior Cerebral Artery / anatomy & histology,  pathology,  physiopathology
Predictive Value of Tests
Prospective Studies
Temporal Lobe / blood supply,  pathology,  physiopathology
Thalamus / blood supply,  pathology,  physiopathology
Tomography, X-Ray Computed
Visual Pathways / blood supply,  pathology,  physiopathology
Reg. No./Substance:
0/Antipsychotic Agents

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