A 64-year-old woman was brought to our emergency department with a 2-day history of right lower limb paralysis and psychomotor retardation. Initial CCT showed a heart-shaped left frontal infarct (Figure). Although she recovered well from the paralysis, over the next few days she developed marked symptoms of depression, with avolition and loss of appetite. She lost 13 kg (20% of her body weight) over the following 5 months and continued to suffer from avolition, daytime fatigue, and concentration difficulties, despite psychotherapy and treatment with citalopram 20 mg q.d. “Post-stroke depression” has an incidence of up to 31 % , especially following left anterior infarctions, as illustrated by the case of “broken heart” after stroke.
Dr. Olympia Kremmyda, Prof. Dr. med. Dr. h. c. Michael Strupp, FRCP, FANA, FEAN, Department of Neurology, Ludwig Maximilians University, Munich, Olympia.firstname.lastname@example.org
Translated from the original German by David Roseveare
Conflict of interest statement: The authors declare that no conflict of interest exists.
Cite this as: Kremmyda O, Strupp M: “Cerebral heartbreak”. Dtsch Arztebl Int 2019; 116: 317. DOI: 10.3238/arztebl.2019.0317