Handling my husbands anger.

Has he been to a neurologist since the symptoms began and had imaging and tests to discount something like a tumor? I know you wrote that he had a stroke and had to learn to walk again, but still I would now take him to a neurologist even though he may have seen one for his stroke episode.

I put his symptoms and behaviors into ChatGPT to see what it may come up with as other possible causes. These are just to guide you as you help him work for a diagnosis. It's probably not an exhaustive list:

(I did not include the obvious stroke or TIA since it was already assumed this was his problem)

"Brain Tumor (e.g., Frontal Lobe Tumor):

Tumors affecting the frontal lobe can lead to mood instability, personality changes, aggression, and loss of coordination.
Vomiting could be linked to increased intracranial pressure.

Encephalitis or Brain Infection:

Inflammation of the brain can cause mood changes, aggressive behavior, vomiting, and motor issues.

Herpes simplex encephalitis, for example, can affect the temporal lobe and cause personality changes.

Delirium or Acute Confusional State:

Sudden changes in mental state, aggression, and disorientation could be related to metabolic disturbances (e.g., electrolyte imbalance, hypoglycemia) or an underlying infection like a urinary tract infection (UTI) or pneumonia in the elderly.

Seizure (Complex Partial Seizure or Post-Ictal State):

Seizures can cause post-ictal confusion, rage, and loss of motor control.
Temporal lobe epilepsy can also cause emotional outbursts and aggressive behavior.

Neurodegenerative Disorders:

Early presentation of conditions like frontotemporal dementia (FTD) can lead to personality changes, aggression, and impaired motor function.

Hydrocephalus (Normal Pressure Hydrocephalus - NPH):

Can cause cognitive changes, gait disturbance, and urinary incontinence, often with mood changes.

Intracranial Hemorrhage (e.g., Subdural Hematoma):

Especially if there was a recent minor head trauma, as it can lead to delayed neurological symptoms including mood changes and mobility issues."

Not on this list is CTE...

"Chronic Traumatic Encephalopathy is a progressive neurodegenerative disorder caused by repeated head trauma, including concussions and subconcussive blows. It is most commonly seen in athletes (especially in contact sports like football, boxing, and hockey) and military personnel exposed to blast injuries, but can occur in anyone with a history of repeated head injuries.

Causes and Mechanism:
CTE is believed to result from repeated traumatic brain injuries (TBIs) that trigger long-term neurodegenerative changes in the brain. The brain trauma leads to the buildup of an abnormal protein called tau, which accumulates in nerve cells and forms tangles. These tangles interfere with normal cell functioning, leading to cell death and brain atrophy over time.

Symptoms:
CTE symptoms often develop years or even decades after the head injuries occurred and progressively worsen over time. The symptoms can include:

Cognitive Impairment:
Memory loss (similar to dementia)
Confusion and disorientation
Impaired judgment and decision-making
Difficulty concentrating

Behavioral and Mood Changes:
Aggression and rage episodes
Depression and suicidal thoughts
Anxiety and paranoia
Mood swings and emotional instability

Motor Symptoms (in later stages):
Gait disturbances (difficulty walking)
Slurred speech
Tremors and coordination issues (similar to Parkinson's disease)

Diagnosis:
Definitive diagnosis can only be made post-mortem by examining brain tissue for tau protein deposits. However, suspected CTE in living individuals is based on clinical history, symptom patterns, and brain imaging (though imaging may not yet definitively show CTE).

Risk Factors:
Repeated concussions or mild traumatic brain injuries
Long careers in contact sports (e.g., football, boxing, hockey)
History of head trauma without proper recovery time between injuries

Treatment: Currently, there is no cure

This man could kill you in a road rage incident or any kind of rage. Which is why you called 911. Which is why your kids have pulled out all the stops for you, their mom. And if they have kids who are actually minor kids, you and they both know why they can’t come over.

If you continue living with him, your family will eventually leave you alone as this is your decision. But understand that you will be managing him alone, with paid help only coming from you as you’re the only one who can pay for it.

Has your husband been diagnosed with Dementia and Alzheimers ? In a way he sounds Bi- polar - After a stroke peoples brains change . My Dad was very Manic , Had Temper tantrums , OCD Behavior , would yell at Me for no reason , Had Multiple Issues . He fell or Had a stroke - we dont really Know ? But he became very sweet after His stay in Intensive care unit and was well taken care of with Physical therapy , a CNA and Tested Multiple times with a Neurologist and His Doctor . I Noticed he was very different with the social worker and understood her but I saw him Bossing around the CNA . The Only thing I could suggest is Couples counseling or getting Him Into see a geriatric psychiatrist . Brain chemistry changes people with Dementia and Alzheimers . He could be getting frustrated and Lashing Out Onto you . The Primary caregiver is usually The target of their anger because they feel safe with you . Basically You have become his nurse and Not a wife . Nothing will go back to ever being the same . You Just have to figure out How Much longer you want to stay On the roller coaster with Dr. Jekyl and Mr. Hyde .

He needs to be tested by a neurologist. If he refuses to go, then you give him an ultimatum, you see a Neurologist and do all the testing suggested, or you will leave my house.

Maybe he is having mini-strokes. It maybe a matter of the right medication.