Underlying cerebrovascular pathology causing secondary psychosis
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Published Version
Date
2021
Authors
Forrest, Clara
Journal Title
Journal ISSN
Volume Title
Publisher
UCC Medical Research and Technology Society
Published Version
Abstract
Case Background: Psychosis can be classified as primary if it is caused by a psychiatric disorder or secondary if it is due to a specific medical condition. Despite there being multiple identified causes of secondary psychosis, making such a diagnosis can prove challenging. Case Details: This case report presents a 57-year-old male who was brought by ambulance to the emergency department following an intentional jump from a first story window due to visual and auditory hallucinations and persecutory paranoid delusions. MRI findings on admission were consistent with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). The patient’s background included an ischaemic stroke with haemorrhagic transformation five years previously. He experienced psychotic symptoms during the immediate recovery period. Prior to this he had no psychiatric history. Discussion: Post-stroke psychosis and the condition of CADASIL are both entities that are relatively rarely described in the literature. However, this may be due to missed diagnosis and therefore not reflective of true prevalence. Conclusion: Identifying a cause-effect relationship and establishing a diagnosis of secondary psychosis can be confounded by many factors. Nevertheless, this patient’s case demonstrates the importance of considering an underlying cause, particularly when the presentation is atypical and there is a temporal relationship between the proposed medical condition and the symptoms of psychosis. Patient Consent Obtained: Yes
Description
Keywords
Cerebrovascular , Secondary psychosis
Citation
Forrest, C. (2021) 'Underlying cerebrovascular pathology causing secondary psychosis', UCC Student Medical Journal, Vol. 2, pp. 67-72. https://doi.org/10.33178/SMJ.2021.1.6