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Although neuropsychiatric symptoms are reported in stroke survivors, details of its prevalence and patterns among young stroke subjects are sparse. In a hospital-based cross-sectional study in India, we recruited 150 young stroke subjects (aged 3 months from ictus. Neuropsychiatric symptoms were evaluated using the Neuropsychiatric Inventory-12 (NPI-12) and self-reported depression with the Centre for Epidemiological Studies - Depression (CES-D) scale. Descriptive statistics were used. Multivariate analysis was performed to identify associated factors. All statistical analyses were carried out using STATA ver. 14.2, StataCorp, TX, USA. Eighty-four (56%; 95% CI: 47.7–64.1%) had ≥ 1 symptoms on the NPI-12 over median time from stroke of 2 years (IQR 2). Self-reported depression was seen in 71 (47.3%). Post-stroke epilepsy was associated with presence of at least one neuropsychiatric symptom. Dementia was associated with increased odds; and having spouse as principal caregiver with reduced odds, of self-reported depression. Multiple infarcts on imaging were associated with self-reported depression (OR: 3.29; 95%CI: 1.31–8.27) and presence of any neuropsychiatric symptom (OR: 3.55; 95% CI: 1.42–8.88). Young stroke survivors frequently have neuropsychiatric symptoms with depression being most common. Presence of multiple infarcts on imaging was associated with self-reported depression and presence of any neuropsychiatric symptom.

A 19-year-old woman reported progressively worsening involuntary head movements since the age of 7. She had visited multiple hospitals and been labelled as having a functional disorder. Detailed evaluation identified a large supra-sellar arachnoid cyst with hydrocephalus. We made a diagnosis of bobble-head doll syndrome, which is only very rarely associated with suprasellar arachnoid cyst. Her symptoms improved rapidly following endoscopic third ventriculostomy with cyst fenestration and gradual decompression of the ventricles. Clearly, not all suppressible movements should be labelled as psychogenic.