White matter lesions and migraine

13th Congress of the International-Headache-Society -- JUN 28-JUL 01, 2007 -- Stockholm, SWEDENWOS: 000247113800129…Int Headache So

İnmenin Erken Döneminde Akut Konfüzyonel Durum

Akut konfüzyonel durum (AKD) ani başlayan ve dalgalanan seyir gösteren geçici organik bir mental durum değişikliğidir. Bu çalışmada inmenin erken evresinde ortaya çıkan AKD sıklığı, kolaylaştıcı faktörler, prognoz üzerine etkisinin belirlenmesi amaçlanmıştır. Gereç ve Yöntem: Prospektif olarak yapılan bu çalışmada 150 olgu çalışmaya alınmıştır. AKD tanısı DSM-IV kriterleri ve Deliryum Derecelendirme Ölçeği esas alınarak konulmuştur. İnme öncesi kognitif fonksiyonlar Informant Questionnaire on Cognitive Decline in Elderly skorlamasına göre değerlendirilmiştir. Serebral magnetik rezonans görüntülemede elde edilen beyaz cevher hiperintensiteleri, Colinergic Hyperintensities Pathway Scale skorlaması ve Fazekas Klasifikasyonuna göre sınıflandırılmıştır. Bulgular: İnme geçiren olgularda AKD oranı % 28 olarak belirlenmiştir. İleri yaş, inme öncesi kognitif etkilenme varlığı, inme öncesi dönem ve akut evrede antikolinerjik ilaç kullanımı, iskemik kalp hastalığı, hemorajik inme, enfeksiyoz ve metabolik problemlerin eşlik etmesi, ihmal ve/veya anozognozi fenomeni birlikteliği, ileri evre lökoaraiozis, yüksek National Institute of Health Stroke Scale, Colinergic Hyperintensities Pathway Scale ve Informant Questionnaire on Cognitive Decline in Elderly skorları AKD'ye girme olasılığını artırmaktadır. AKD gelişen olgularda fonksiyonel ve vital prognoz girmeyenlere göre daha kötü seyretmektedir. Sonuç: İnme geçiren olgular özellikle akut evrede bilinç değişiklikleri açısından yakından takip edilmelidir. İnmenin akut evresinde AKD'ye neden olabilecek metabolik ve enfeksiyöz problemlerin tanınıp tedavi edilmesi ve antikolinerjik medikasyondan mümkün olduğunca kaçınılması tablonun önlenebilmesi açısından önem taşımaktadır.Acute confusional state is a change of mental status with sudden onset and fluctuating course. This study was aimed at determining the frequency of ACS that appears at early (acute) stage of stroke, its predisposing factors, and its impact on prognosis. Material and Method: 150 cases were included in this study which was performed prospectively. ACS was diagnosed on the basis of DSM-IV criteria and of Delirium Rating Scale. Pre-stroke cognitive functions were evaluated according to Informant Questionnaire on Cognitive Decline in Elderly scoring. White matter hyperintensities detected on cerebral magnetic resonance imaging were classified according to Cholinergic Hyperintensities Pathway Scale scoring. Results: The rate of ACS was determined as 28% in cases who experienced stroke. Advanced age, presence of cognitive decline, use of anticholinergic drugs during pre-stroke period and in acute stage, ischemic heart disease, hemorrhagic stroke, concomitant, infectious and metabolic problems, concurrent neglect and/or anosognosia phenomenon, advanced stage leukoaraiosis, high National Institute of Health Stroke Scale, Colinergic Hyperintensities Pathway Scale and Informant Questionnaire on Cognitive Decline in Elderly scores increase the possibility of entering acute confusional state. Functional and vital prognoses follow a poorer course in those who enter ACS than in those who do not. Conclusion: Cases who experienced stroke should be monitored closely, particularly in acute stage, with respect to cognitive changes. In the acute stage of stroke, diagnosing and treating metabolic and infectious problems that may cause ACS, and avoiding as much as possible anticholinergic medications is (are) important in terms of preventing the manifestation

Acute Confusional State at Early Stage of Stroke

WOS: 000318549800004Acute confusional state is a change of mental status with sudden onset and fluctuating course. This study was aimed at determining the frequency of ACS that appears at early (acute) stage of stroke, its predisposing factors, and its impact on prognosis. Material and Method: 150 cases were included in this study which was performed prospectively. ACS was diagnosed on the basis of DSM-IV criteria and of Delirium Rating Scale. Pre-stroke cognitive functions were evaluated according to Informant Questionnaire on Cognitive Decline in Elderly scoring. White matter hyperintensities detected on cerebral magnetic resonance imaging were classified according to Cholinergic Hyperintensities Pathway Scale scoring. Results: The rate of ACS was determined as 28% in cases who experienced stroke. Advanced age, presence of cognitive decline, use of anticholinergic drugs during pre-stroke period and in acute stage, ischemic heart disease, hemorrhagic stroke, concomitant, infectious and metabolic problems, concurrent neglect and/or anosognosia phenomenon, advanced stage leukoaraiosis, high National Institute of Health Stroke Scale, Colinergic Hyperintensities Pathway Scale and Informant Questionnaire on Cognitive Decline in Elderly scores increase the possibility of entering acute confusional state. Functional and vital prognoses follow a poorer course in those who enter ACS than in those who do not. Conclusion: Cases who experienced stroke should be monitored closely, particularly in acute stage, with respect to cognitive changes. In the acute stage of stroke, diagnosing and treating metabolic and infectious problems that may cause ACS, and avoiding as much as possible anticholinergic medications is (are) important in terms of preventing the manifestation