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Neuropsychiatric Symptoms of Cerebrovascular Diseases pp 3–29Cite as

Delirium in Stroke Patients

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Part of the book series: Neuropsychiatric Symptoms of Neurological Disease ((NSND))

Abstract

Delirium is an acute, transient, and fluctuating disorder of consciousness, attention, and cognition. It is frequent at the acute phase of stroke, occurring in approximately one-quarter of stroke patients. Despite this high frequency, the physiopathology of delirium in stroke patients remains largely unknown. Delirium may be the consequence of stroke itself but is, in a large number of cases, the consequence of a preexisting cognitive decline and of coexistent intercurrent disorders such as a metabolic disturbances or infections. This suggests that when delirium occurs in a stroke patient, a comprehensive search for precipitating factors must be performed. Delirium is a predictor of worse outcome after stroke: it is associated with a longer duration of hospital stay, a higher mortality, a worse functional outcome, and a higher risk of poststroke cognitive decline. No large randomized trial has been conducted in delirious patients, in particular after stroke. Treatment recommendations are therefore based on expert’s opinions: supportive and environmental measures, treatment programs, and trained nurses may be useful; drug treatment must be restricted to selected patients, after a careful evaluation of the benefice/risk balance. Orally low dose of haloperidol or atypical antipsychotic drugs remains to date the first-choice treatment.

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  1. E.A. 1046 Department of Neurology, Stroke Unit, University Hospital of Lille, Lille, 59037, France

    Hilde Henon & Didier Leys

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  1. Hilde Henon
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  2. Didier Leys
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Correspondence to Hilde Henon .

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  1. , Serviço de Neurologia, Hospital de Santa Maria, Av. Prof. Egas Moniz, Lisboa, 1649-035, Portugal

    José M. Ferro

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Henon, H., Leys, D. (2013). Delirium in Stroke Patients. In: Ferro, J. (eds) Neuropsychiatric Symptoms of Cerebrovascular Diseases. Neuropsychiatric Symptoms of Neurological Disease. Springer, London. https://doi.org/10.1007/978-1-4471-2428-3_1

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  • DOI: https://doi.org/10.1007/978-1-4471-2428-3_1

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