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Acute confusional states in the elderly: a radiological evaluation
H Koponen1, L Hurri, U Stenbäck
1Moisio Hospital, Mikkeli, Finland.
Acta Psychiatrica Scandinavica
|December 1, 1987
Summary
This study found that elderly patients with delirium showed specific brain structural differences, including enlarged ventricles and fissures, and more brain infarcts, compared to controls. These findings highlight the role of underlying brain conditions in delirium development.
Area of Science:
- Neuroimaging
- Geriatric Psychiatry
- Neurology
Background:
- Delirium is a common acute neuropsychiatric syndrome in elderly patients.
- Structural brain abnormalities are suspected to predispose individuals to delirium.
Purpose of the Study:
- To investigate differences in brain structure between elderly patients with delirium and cognitively normal controls using computed tomography (CT).
- To identify specific CT markers associated with delirium in the elderly.
Main Methods:
- Computed tomography (CT) scans of the head were performed on 35 patients diagnosed with delirium (DSM-III criteria) and 25 healthy controls.
- Quantitative measurements of brain structures, including sulcal width, ventricular indices, and the presence of low attenuation areas, were analyzed.
Main Results:
- No significant differences in mean age or cortical atrophy scores were found between groups.
- Delirious patients exhibited significantly different frontal horn and cella media indices, and wider left Sylvian fissures and third ventricles.
- A higher prevalence of low attenuation, brain infarct-type areas was observed in delirious patients.
Conclusions:
- Structural brain changes, particularly enlarged ventricles and fissures, and evidence of brain infarcts, are associated with delirium in elderly patients.
- The study reinforces the significant predisposing role of underlying structural brain diseases, such as dementias and Parkinsonism, in the development of acute delirium.