ACUTE CONFUSIONAL STATE (DELIRIUM) SOON AFTER STROKE IS ASSOCIATED WITH HYPERCORTISOLISM

被引：56

作者：

GUSTAFSON, Y ^{[1
]}

OLSSON, T ^{[1
]}

ASPLUND, K ^{[1
]}

HAGG, E ^{[1
]}

机构：

[1] UMEA UNIV,DEPT MED,S-90187 UMEA,SWEDEN

来源：

CEREBROVASCULAR DISEASES | 1993年 / 3卷 / 01期

关键词：

ACUTE CONFUSIONAL STATE; DELIRIUM; STROKE; DEXAMETHASONE SUPPRESSION TEST; HYPERCORTISOLISM;

D O I：

10.1159/000108667

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Acute confusional state (ACS), or delirium according to DSM-III-R, and the function of the hypothalamic-pituitary-adrenal-axis were studied in 83 patients soon after an ischemic supratentorial stroke. ACS was common (35/83 = 42 %). Patients with stroke had higher cortisol levels after dexamethasone than an elderly healthy control population (median = 75 and 31 nmol/l, respectively; p < 0.001). The stroke patients with ACS had higher post-dexamethasone cortisol levels than stroke patients without ACS (median = 98 vs. 59 nmol/l; p < 0.001). A logistic regression analysis revealed that ACS in stroke patients was independently associated with high cortisol levels after dexamethasone, extensive motor impairment and left-sided brain lesion. There is a close association between ACS and hypercortisolism in stroke patients, not explained by other known determinants of ACS. The possibility that hypercortisolism is involved in the pathophysiology of confusion caused by an acute stroke should be considered.

引用

页码：33 / 38

页数：6

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