When do you consider attributing isolated psychosis to an acute ischemic stroke?

1. Differential diagnosis: Making sure to rule out more common etiologies, such as delirium, neurocognitive disorder, medication/drug-induced, etc.
2. Location: Lesions have largely been reported in the right hemisphere, particularly frontal, temporal, and parietal regions. Subcortical regions such as the thalamus, brainstem, mid-brain, and basal ganglia have also been implicated. Some studies have noted psychotic features to be more common in patients who experienced ischemic stroke rather than hemorrhagic.
3. T...

I would like to know what is being referred to as psychosis. An altered mental state, following an acute CVA, would be more likely attributable to delirium. Since it is referred to as “isolated,” I assume this is not recurrent, meaning that the patient does not have a history of psychosis. Delirium after CVA is not uncommon in the Neuro ICU setting. That said, more information would be very helpful.

I’ve seen extreme agitation during an evolving stroke.

I’ve also seen manic episodes following post-minor ischemic insults, with no other identifiable etiology.

And I’ve seen another case as well.