follow up to stroke and dementia

Posted by Jeanne on June 16, 1999 at 11:07:31
Thank you for the response to my last questionCan you help me on this. Could he have dementia from hisright hemispheric stroke 5 yrs ago and still appear normal in all other aspects . He has terrible outburst of anger just at me. He Has become absessed with sex... I think he honestly believes that one of our sons and me have cheated him out of his money and that I am having an affair..(i am 70 and battling cancer...I am too tired to have an affair..... He also believes that our dead daughter comes to him and tells him he can walk.Because of his recent erratic behavior they tested him for dementia.. He tested above the cut-off for dementia but on the trail making test he had a poor performance but the Dr. said that that was because of his anger towards me . He gave him a clean bill of healthand said he was competant.He was not like this before his stroke . Just the last yr.  Could he appear normal and still have dementia..... Thank you

Posted by HFHS.MD.DE on June 21, 1999 at 19:09:02
Dear Jeanne;
may Dementia results from a broad loss of intellectual functions (one of which may be memory loss) due to diffuse organic disease of the brain of sufficient severity to impair social and/or occupational functioning. As I mentioned in my previous response,the causes of dementia are numerous and stroke is one of them.  Patients who are in the early phase of dementia may appear "normal" and tests done at this stage may turn out normal too. If he had defects on the Trail-making test, then he has cognitive decline. This cannot be due to his anger at you.  I would like to emphasize the importance of having your husband evaluated for other medical reasons that could be causing his change in behavior.  At this point, I think it will be more beneficial to have his behavior under control with medications and this could be done by a psychiatrist. A thorough evaluation for dementia will be more possible with the behavior under control. A stroke can cause problems other than dementia.  A stroke could cause psychosis causing paranoia and jealousy. This too can be treated with medication.
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Key words:Dementia/Stroke/psychosis