3.2 CEREBROVASCULAR DISORDERS
Cerebrovascular disorders (CVD) are
classified to ischemic phenomena and hemorrhagic phenomena. Ischemic
phenomena include infarction and transient ischemic attacks, while
hemorrhagic phenomena include intraparanchymal hemorrhage, subarachnoid or
intraventricular hemorrhage, and subdural or epidural haematoma (Robinston
and Starkstein, 2002). The only disorder that is listed in the DSM-IV that
is specific to CVD is vascular dementia. However, many psychiatric
disorders have been reported to develop in patients who have CVD.
Depression is produced by lesions in the left frontal pole and subcortical
strokes such as within the left thalamus and caudate. Anxiety usually
occurs when there is cortical infarction rather than isolated subcortical
damage. Lesions in the orbital frontal lobe may cause some cases of
organic anxiety or obsessive compulsive disorder. Right-sided temporal,
parietal, and occipital strikes have been described in association with
visual hallucinations. An accumulation of lesions, as in multi-infarct
dementia, leads to an increasing risk for organic hallucinosis due to CVD
(Absher and Toole, 2000). |
