Klimiec Elzbieta, Dziedzic Tomasz, Kowalska Katarzyna, Slowik Agnieszka, Klimkowicz-Mrowiec Aleksandra
*Department of Neurology, Jagiellonian University Medical College †Department of Neurology, University Hospital, Krakow, Poland.
Cogn Behav Neurol. 2016 Dec;29(4):174-189. doi: 10.1097/WNN.0000000000000110.
Delirium is a transient condition characterized by sudden and fluctuating disturbances in cognitive function. The condition can be considered a sign of the brain's vulnerability and diminished resilience to insult. Among the many clinical manifestations are cognitive, psychomotor, and sleep disturbances. Delirium is associated with longer hospital stays, worse functional outcomes, and higher mortality. Although up to 48% of patients who have had a stroke develop delirium, the condition has been studied much less in these patients than in general medicine, surgical, and intensive care patients. Coexisting neurologic deficits in patients with stroke limit the use of screening tools that are widely accepted in other populations. The variability of reported assessment methods highlights the need for delirium screening guidelines in stroke. Further, risk factors that are specific to stroke may play an important role in the etiology of delirium, along with such well-known factors as older age and infections. The delirium literature lacks data on differences in clinical manifestations and course in the various types of stroke. Here we review predisposing factors, diagnostic methods, and biomarkers of delirium in stroke and discuss aspects that need further research.
谵妄是一种短暂性病症，其特征为认知功能突然出现波动紊乱。该病症可被视为大脑脆弱性以及对损伤恢复力减弱的一种迹象。其临床表现包括认知、精神运动和睡眠障碍。谵妄与住院时间延长、功能预后较差以及死亡率较高相关。尽管高达48%的中风患者会发生谵妄，但相较于普通内科、外科和重症监护患者，对中风患者谵妄的研究要少得多。中风患者并存的神经功能缺损限制了在其他人群中广泛使用的筛查工具的应用。所报告评估方法的多样性凸显了中风患者谵妄筛查指南的必要性。此外，中风特有的危险因素可能在谵妄病因中发挥重要作用，同时还有诸如高龄和感染等众所周知的因素。谵妄相关文献缺乏关于各类中风临床表现和病程差异的数据。在此，我们综述中风患者谵妄的诱发因素、诊断方法和生物标志物，并讨论需要进一步研究的方面。
