title: Psychosis post corona radiata and lentiform nucleus infarction.
abstract: Complications of stroke can include neuropsychiatric symptoms. However, post-stroke psychosis is rare. We report a case where an acute presentation of psychosis, depression and fluctuating cognitive impairment in a middle-aged man turned out to be related to a silent brain infarction. The patient had a background of poorly controlled type 2 diabetes mellitus with glycated haemoglobin level of 9.0-11.0%, hypertension and ischaemic heart disease. His CT brain results showed multifocal infarct with hypodensities at bilateral lentiform nucleus and bilateral corona radiata. His strong genetic predisposition of psychosis and a history of brief psychotic disorder with complete remission 3 years prior to the current presentation might possibly contribute to his post-stroke atypical neuropsychiatric presentation, and posed diagnostic challenges. He showed marked improvement with risperidone 6 mg nocte, chlorpromazine 50 mg nocte and fluvoxamine of 200 mg nocte. The need of comprehensive treatments to modify his stroke risk factors was addressed.
authors.affiliation: Department of Psychiatry, UKM Medical Centre, Kuala Lumpur, Wilayah Persekutuan, Malaysia Universiti Sains Islam Malaysia, Nilai, Malaysia.
authors.forename: Khadijah Hasanah Abang
authors.initials: KH
authors.lastname: Abdullah
authors.affiliation: Department of Psychiatry, UKM Medical Centre, Kuala Lumpur, Wilayah Persekutuan, Malaysia.
authors.forename: Suriati Mohamed
authors.initials: SM
authors.lastname: Saini
authors.affiliation: Department of Psychiatry, UKM Medical Centre, Kuala Lumpur, Wilayah Persekutuan, Malaysia.
authors.forename: Shalisah
authors.initials: S
authors.lastname: Sharip
authors.affiliation: Department of Psychiatry, UKM Medical Centre, Kuala Lumpur, Wilayah Persekutuan, Malaysia.
authors.forename: Abdul Hamid Abdul
authors.initials: AH
authors.lastname: Rahman
mesh_terms: D003072:Cognition Disorders / Q000209:etiology; D003342:Corpus Striatum / Q000098:blood supply* / Q000473:pathology; D003863:Depression / Q000209:etiology; D003937:Diagnosis, Differential; D006801:Humans; D007238:Infarction / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000175:diagnosis / Q000209:etiology*; D020521:Stroke / Q000523:psychology*
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