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Neurocritical Care
Published in: Neurocritical Care 3/2016

01-06-2016 | Original Article

Hematoma Locations Predicting Delirium Symptoms After Intracerebral Hemorrhage

Authors: Andrew M. Naidech, Kelly L. Polnaszek, Michael D. Berman, Joel L. Voss

Published in: Neurocritical Care | Issue 3/2016

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Abstract

Background

Delirium symptoms are associated with later worse functional outcomes and long-term cognitive impairments, but the neuroanatomical basis for delirium symptoms in patients with acute brain injury is currently uncertain. We tested the hypothesis that hematoma location is predictive of delirium symptoms in patients with intracerebral hemorrhage, a model disease where patients are typically not sedated or bacteremic.

Methods

We prospectively identified 90 patients with intracerebral hemorrhage who underwent routine twice-daily screening for delirium symptoms with a validated examination. Voxel-based lesion–symptom mapping with acute computed tomography was used to identify hematoma locations associated with delirium symptoms (N = 89).

Results

Acute delirium symptoms were predicted by hematoma of right-hemisphere subcortical white matter (superior longitudinal fasciculus) and parahippocampal gyrus. Hematoma including these locations had an odds ratio for delirium of 13 (95 % CI 3.9–43.3, P < 0.001). Disruption of large-scale brain networks that normally support attention and conscious awareness was thus associated with acute delirium symptoms.

Conclusions

Higher odds ratio for delirium was increased due to hematoma location. The location of neurological injury could be of high prognostic value for predicting delirium symptoms.
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Metadata
Title
Hematoma Locations Predicting Delirium Symptoms After Intracerebral Hemorrhage
Authors
Andrew M. Naidech
Kelly L. Polnaszek
Michael D. Berman
Joel L. Voss
Publication date
01-06-2016
Publisher
Springer US
Published in
Neurocritical Care / Issue 3/2016
Print ISSN: 1541-6933
Electronic ISSN: 1556-0961
DOI
https://doi.org/10.1007/s12028-015-0210-1

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