EMOTIONAL STRESS BEFORE STROKES: A PRELIMINARY REPORT OF 20 CASES

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Abstract
Twenty patients with cerebral vascular disorders have been presented. Most were under the age of 50. In 13 cases there was non-traumatic intracranial hemorrhage, and in eight cases organic hemiparesis. One patient (Case 3) had both subarachnoid hemorrhage and hemiparesis. In 13 of these cases there were long-standing personality difficulties preceding the stroke, and in 15 a special emotional stress which immediately preceded the stroke; in 8 cases both factors were present. Angiograms technically suitable for study of spasm of the cerebral arteries were available in 15 cases. In all of these there was an excessive tendency to arterial contraction. This spastic tendency may be one of the bodily expressions of the emotional disturbance. Ischemia resulting from excessive arterial contraction doubtless contributes to the pathologic changes in the brain and its blood vessels. The high incidence of major emotional problems preceding cerebral strokes warrants further attention.

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