Oldenbeuving A W, de Kort P L M, Jansen B P W, Roks G, Kappelle L J
Department of Neurology, St Elisabeth Hospital, Tilburg, The Netherlands.
Int J Stroke. 2007 Nov;2(4):270-5. doi: 10.1111/j.1747-4949.2007.00163.x.
Delirium is a complex neuropsychiatric syndrome characterized by disturbances of consciousness, attention, cognition, and perception. It may be the presenting feature of acute stroke, but more often it complicates the clinical course in the early stage of rehabilitation.
Risk factors for delirium are older age, pre-existing cognitive decline, metabolic disturbances, infections, and polypharmacy. Recognition of delirium in patients with stroke is important because of its association with a longer stay in the hospital, a poor functional outcome, and an increased risk of developing dementia. The diagnosis may be difficult because of the fluctuating course and the neurological deficits that are caused by the stroke. Nonpharmacological preventive measures, early identification, and additional medical intervention are the key measures in the management of delirium after stroke.
This review describes incidence, risk factors, pathophysiology, diagnostic tools, and management of delirium in patients with a recent stroke.
谵妄是一种复杂的神经精神综合征,其特征为意识、注意力、认知和感知障碍。它可能是急性卒中的首发症状,但更常见的是在康复早期使临床病程复杂化。
谵妄的危险因素包括老年、既往存在认知功能减退、代谢紊乱、感染和多种药物联用。识别卒中患者的谵妄很重要,因为它与住院时间延长、功能预后不良以及发生痴呆的风险增加有关。由于病程波动以及卒中所致的神经功能缺损,诊断可能会很困难。非药物预防措施、早期识别和额外的医学干预是卒中后谵妄管理的关键措施。
本综述描述了近期卒中患者谵妄的发病率、危险因素、病理生理学、诊断工具及管理。