Post-stroke mania late in life involving the left hemisphere

Objective: Although post-stroke depression is well recognised, post-stroke mania has rarely been reported and researched. Most reported cases have involved lesions of the non-dominant hemisphere. We report a case of late-onset mania following stroke with a lesion in the dominant hemisphere. Clinical picture: A 78-year-old, right-handed man developed sudden cognitive deficits and manic symptoms. Investigations revealed lesions in the dominant hemisphere. Treatment: Pharmacological intervention was complicated by side effects. Outcome: His symptoms resolved gradually over 2 months and he was back to normal in 4 months. Conclusions: We would encourage further study in the area of post-stroke mania and especially in relation to the site of the lesion in the brain.