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  • The Clinic Neurospychiatry of Stroke

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    Cazan Stelian
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    The clinic neurospychiatry of stroke

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    8 views261 pages

    The Clinic Neurospychiatry of Stroke

    Uploaded by

    Cazan Stelian

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    of 261
    The clinical neuropsychiatry of stroke Cognitive, behavioral, and emotional disorders following vascular brain injury ROBERT G. ROBINSON CAMBRIDGE UNIVERSITY PRESS and he smoked cigarettes continual throughout the interview. His eg was constantly bouncing and he had a naticeabe tremor of hs "ght hand. Te patent stated that he fet exttemely depressed ard \was fing hopeless about the future He sated that he morted to Feturnto work and felt he was a faite becauee he ws unable odo 50. He had ost interest in al of his rewus aces and id not go ‘tof the house. Hs son ha jst bought anew car and wanted {ake the patient fora ride out the patient refused to leave hs home: He eft home onl to see his doctors, ‘On cognitive examination thepatent was not onented tothe year nor ded he know the date of the month or the place were the interview was being conducted. The patient's real as intact. and he wasableto serial subtract 7sbeginaingurth 10D ut was unaDle to wnte a sentence and was unabe ta draw the intersecting penta ‘9015 onthe minv-mental state examination The pavent was startedon amtrptyine and his dose wasinceased to 75mg daly Exact 2 weeks after reaching dose of 100%m9 arntnptyin, the patents depression remitted. He ro longer had feelings of amet, depression, thoughts of death, felings of hope lesness,o sleep disturbance. The patent, however. compatned of Sedation and marked constipation. He was sated to 759 noe ‘niptyine and was abet torte tis medicaton The pant ws not seen aftr that fr 18 months. When seen ‘298i he reported that he had been dong wel during the ner aithovgh he continued tobe unable to walk. The patient fr the fist time, ale to take care of many of his complex daly acts, Such as setinghs father's estate, and manag hs finer vest iments, He stated that he had no slep or appetite disturbance snd ‘had gained appronmatey 10lb (25k) during the past yes The patent then stated that he woulalketotaper af his 75mg nosh. line wich was scheduled to occur over 3 -month petiog Three months later the patient etvened and stated thot when his rnortnpyine dose got to 25mg he began to experience increasing anvety, tabi, deoesson, seep difcuty low energy, end fet that he was urable to cope withthe daly stresses, HS dose wos increased back to 751mg and within 3 weeks he reported tht he ‘mood was stable, that he was sleeping wel and hs eopeite Wes ‘geod, Three months ater, ater the patient's daughter hed mares he eported that he planned to get an electri wheeicharso tat he ‘ould get around mare easly Heated that he hed had no peviodsof

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