The Use of Ultrabrief Left Unilateral Electroconvulsive Therapy in a Patient With Cerebral Aneurysms and Right-Sided Encephalomalacia and Stroke: A Case Report

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To the Editor:
We are presenting a case of a 50-year-old right-handed woman with a long-standing history of major depressive disorder. In 2002, she underwent 2 brain surgeries with trial of clipping of 2 aneurysms in basilar and anterior communicating arteries. However, she developed brain edema during the procedure. She had a third successful endovascular surgery in 2003, where she had coiling of her aneurysms; however, it was complicated by ischemic stroke on the right side, resulting in encephalomalacia. Patient’s ischemic stroke affects mainly her cognitive functions. Patient’s quality of life has been declining, and she became disabled because of severe depressive symptoms in the context of borderline cognitive impairment per clinical and neuropsychological assessments. Patient presented to our interventional clinic for further treatment of medication-resistant depression. Her baseline PHQ-9 (9-item Patient Health Questionnaire) was 21, the CGI (Clinical Global Impression) of severity of illness was 6/7, and the MOCA (Montreal Cognitive Assessment) was 23.

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