Warning compulsive behavior preceding acute ischemic stroke.

On April 23, at 8: 00, she developed a deep comatose state with tetraplegia. She was admitted at 13: 00 to our intensive care unit. Multimodal stroke MRI with diffusion-weighted imaging revealed multiple cerebellar infarctions and brainstem involvement. Magnetic resonance angiography (MRA) showed a mid-basilar thrombosis ( fig. 1 ). Dear Sir, Abrupt onset of compulsive behavior (CB) without other neurologic or psychiatric signs or symptoms rarely precedes an acute stroke. We describe 2 young women who developed an acute CB followed by an ischemic stroke. These two cases raise concern about the need to promptly perform the appropriate brain imaging studies in patients who develop acute CB without neurological signs or symptoms or history of psychiatric disease.