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Department of Psychiatry and Behavioral Science, Johns Hopkins University School of Medicine, Baltimore, Maryland.
The prevalence, diagnosis, clinical presentation, evolution, and treatment of depression and mania following stroke are discussed. Among the many studies presented in the review is one that indicates major depression following right hemisphere lesions is associated with a positive family history of psychiatric disorder and lesions involving the parietal cortex. The co-occurrence of major depression and generalized anxiety disorder is associated with cortical lesions, while depression alone is associated with subcortical lesions. A recent study has also shown a strong association between mania and direct or indirect dysfunction of the basotemporal cortex in the right hemisphere. Possible mechanisms for both mania and depression following stroke are presented, and ideas for future directions in research are suggested.
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