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Case Study – Delirium in Stroke

Clinical pearl and Conclusion TOPIC

  • Clinical Pearl
    • Not every patient with confusion following a stroke has delirium.
    • Remember that delirium is characterized by a reduced level of consciousness of acute onset and a fluctuating course.
    • Stroke patients with confusion who do not have reduced consciousness should not be labeled as having delirium.
    • Evaluate the patient clinically to identify a cause for the confusion, particularly an extension or hemorrhagic transformation the infarct.
    • An older patient with cognitive impairment may have confusion as part of BPSD
  • Conclusion
    • Delirium is an under-recognized but common and important complication of stroke.
    • Recent research suggests that 25% of stroke patients develop delirium.
    • Advanced age, pre-existing cognitive impairment, cortical stroke and increased stroke severity are among the factors that increase the risk of delirium in stroke.
    • Recognized risk factors and triggers of delirium mean that detection and possible prevention of delirium is an achievable goal.
    • Delirium has a negative impact on morbidity, including long-term cognitive outcome, and mortality.
    • The effect of delirium on post-stroke allied health participation has not been researched.