Abstract TP562: Clinical and Brain-regional Characteristics Associated With Delirium Occurred After Acute Ischemic Stroke

Abstract

Background: Post-stroke delirium is not uncommon in acute ischemic stroke patients. We evaluated the clinical and brain-regional characteristics associated with the development of delirium in acute ischemic stroke patients. Method: We prospectively included 444 consecutive patients, who were diagnosed as acute ischemic stroke from August 2017 to March 2018. All patients daily screened for delirium using the Confusion Assessment Method during the entire admission period. After the screen, the delirium was diagnosed using the criteria of the Diagnostic and Statistical Manual of Mental Disorders (fifth edition). Motor subtypes (hyperactive, hypoactive, and mixed) of individual delirium was measured by the Korean Version of Delirium Motor Subtype Scale. Clinical characteristics and subtypes of delirium were compared by the location of the initial stroke lesion (total anterior [TACI], partial anterior [PACI], posterior circulation infarctions [POCI] and lacunes) and by the involvement of cognition-related brain regions (angular gyrus, medial temporal or frontal lobe, anterior and medial thalamus, and/or caudate nucleus). Results: Post-stroke delirium occurred in 43 (9.7%) of the total patients. Hyperactive subtype (27 patients, 62.8%) of delirium were more frequent than hypoactive (2, 4.7%) and mixed ones (12, 27.9%). The post-stroke delirium more frequently occurred in PACI (19, 44.2%) and POCI (17, 39%) rather than TACI (4, 9.3%) and lacunes (3, 7%, p <0.001). Cognition-related brain regions was involved in 48 (10.8%) of the total patients, but, showed significantly higher delirium occurrence (22 of 48 patients, 51.2%) than the other region involvement (26 of 401, 6.5%, p <0.001). Delirium started within a mean of 1.6±1.6 (SD) days after onset of stroke, and continued for a mean of 7.2±6.7 days after treatment began. By the delirium subtypes, hyperactive (4.9±5.3 days) had shorter duration of delirium than hypoactive (12.5±6.4) and mixed subtype (11.4±7.4, p <0.001). Conclusion: The present study shows the clinical and brain-regional characteristics of post-stroke delirium patients. The regional and delirium subtype characteristics could be useful to expect the occurrence and duration of delirium for acute ischemic stroke patients.