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Computed tomography findings in delirium.

H Koponen¹, L Hurri, U Stenbäck

¹Department of Neurology, University Central Hospital, Kuopio, Finland.

The Journal of Nervous and Mental Disease

|April 1, 1989

Summary

Elderly patients experiencing delirium show significant brain atrophy and focal changes, particularly in the right hemisphere. Structural brain diseases strongly predispose older adults to developing delirium.

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Area of Science:

Neurology
Geriatrics
Radiology

Background:

Delirium is a common neuropsychiatric syndrome in elderly patients.
Its association with structural brain changes requires further investigation.

Purpose of the Study:

To evaluate focal brain changes and generalized atrophy in elderly patients with delirium using computerized tomography (CT).
To explore the relationship between these brain changes and delirium severity.

Main Methods:

Computerized tomography (CT) of the head was performed on 69 elderly patients diagnosed with delirium (DSM-III criteria) and 31 neurological controls.
Statistical analysis compared age, sex distribution, ventricular dilatation, cortical atrophy, and focal changes between groups.
Correlation between sylvian fissure width and Mini-Mental State Examination (MMSE) scores was assessed.

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Main Results:

Delirious patients exhibited significantly greater ventricular dilatation and cortical atrophy compared to controls.
Focal brain changes were more prevalent in delirious patients, predominantly in right-hemisphere association areas.
A significant correlation was found between sylvian fissure width and MMSE scores.

Conclusions:

Structural brain diseases, including dementias and parkinsonism, play a significant predisposing role in the development of delirium in the elderly.
Generalized brain atrophy and focal lesions, especially in the right hemisphere, are associated with delirium in older adults.