Objectives:
We aim to study the double-way relation between depression and stroke.

Background and Aims:
Post-stroke depression is a common complication in stroke rehabilitation. More recently, depression has, also, been studied as a risk factor for ischemic stroke.

Materials and Methods:
We report the case of a patient with multiple strokes and a history of recurrent depression. We also conducted a review of the literature using the databases “PubMed” and “ScienceDirect” and the keywords “depression”, “stroke”, “risk factor”, “pre-stroke depression”, “post-stroke depression”.

Results and Conclusions:
Results:
Mr. E.J, 57years old has been hospitalized in a psychiatric hospital (Razi Hospital) after a suicide attempt. He is married and has no children (primary sterility of the couple). He had a medical history of 3 ischemic strokes (the most recent dates to 1 month before his hospitalization). He also suffered for about twenty years from a recurrent depression with a poor compliance to treatment. During his last hospitalization, we diagnosed a post-stroke depression and we prescribed an antidepressant treatment (fluoxetine), with anxiolytic medication. Nevertheless, two weeks after, he developed sudden left hemiplegia.Imaging studies showed ischemic stroke
Conclusion:
The case of our patient supports the fact that depression may be an important contributor as well as a complication of ischemic stroke.Therefore,pre-stroke depression increases odds of post-stroke depression.Early identification of patients with a history of depression and those at high risk of depression after stroke, would enable the early implementation of effective management and prevention strategies for depressionand improve outcomes in these patients.

A CASE OF MULTIPLE STROKES: WHEN DEPRESSION IS BOTH A RISK FACTOR AND A COMPLICATION