Confusion or delirium in patients with posterior cerebral arterial infarction.
OBJECTIVE
To identify the possible anatomic sites and risk factors for the development of confusion or delirium in patients with posterior cerebral arterial (PCA) infarction.


METHODS
Twenty-nine patients aged 34-86 years with PCA infarction were divided into two groups: one with and the other without perturbed mentation. The clinical and laboratory data, including neuroimages, were retrospectively reviewed. Student-t, chi-square and Fisher's exact tests were performed for data analysis.


RESULTS
Confusion or delirium tended to develop in the left (10/13) or bilateral (5/5) PCA infarction as compared to the right PCA infarction (3/15) (P< 0.05) and medial occipital-temporal gyri involvement was crucial for its development (P< 0.05). The results were also noted in the patients with first-ever stroke. Diabetes mellitus was the sole biochemical factor to be associated with confusion or delirium (P< 0.01).


CONCLUSIONS
The involvement of the medial occipito-temporal gyri, especially on the left side was the pivotal factor for the development of confusion or delirium in patients with PCA infarction. Higher prevalence of diabetes mellitus was also observed in the group with mental perturbation.
Shih
Hsu-Tzu
HT
Department of Neurology, China Medical University Hospital, Taichung, Taiwan.
Huang
Wei-Shih
WS
Liu
Chung-Hsiang
CH
Tsai
Tzung-Chang
TC
Lu
Chung-Ta
CT
Lu
Ming-Kuei
MK
Chen
Ping-Kun
PK
Tseng
Chun-Hung
CH
Jou
Shuo-Bin
SB
Tsai
Chon-Haw
CH
Lee
Cheng-Chun
CC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003221:Confusion / Q000209:etiology*; D003693:Delirium / Q000209:etiology*; D017548:Echocardiography, Transesophageal; D004562:Electrocardiography; D005260:Female; D006801:Humans; D020762:Infarction, Posterior Cerebral Artery / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors