title: [Cerebral embolism and psychosis with special reference to cardiac surgery (author's transl)].
abstract: Cerebral embolism can manifest itself in certain cases as pure psychosis. In the absence of neurological symptoms it might be mistaken for schizophrenia or manic-depressive psychosis. Cardiac disease and cardiac surgery involve a high risk of embolism. Microembolism plays a special role with extracorporal circulation. There is a significant increase of postoperative psychosis in cases with E.C.C. in comparison to closed heart surgery. Immediately post-operatively there occurs what has been described as the "catastrophic reaction" or "immobilization syndrome". This reaction is in fact an akinetic, parkinsonian-like state for which there is good evidence that it is due to transient microembolism of the basal ganglia ("striatum apoplexy"). After its disappearance around the 3rd--5th day "cardiac psychoses" (cardiac delirium) may manifest themselves. Patients who develop these "late" psychoses have a significantly higher correlation with endogenous psychoses in their family histories. On the psychopathological level--in the absence of disturbances of consciousness and orientation--it is not possible to differentiate between "exogenous" and "endogenous" psychosis. A special type of psychopathological reaction is dependent, as in neurological disease, on the severity of brain damage, its localization and on hereditary factors.
mesh_terms: D001479:Basal Ganglia / Q000098:blood supply; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D005112:Extracorporeal Circulation / Q000009:adverse effects*; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000209:etiology*; D019965:Neurocognitive Disorders / Q000209:etiology*; D010302:Parkinson Disease, Secondary / Q000209:etiology; D011618:Psychotic Disorders / Q000235:genetics
vernacular_title: Hirnembolie und Psychose. Unter besonderer Berücksichtigung der Basalganglienapoplexie bei Herzoperationen mit extrakorporaler Zirkulation