Association of White Matter Lesions, Cerebral Atrophy, Intracranial Extravascular Calcifications, and Ventricular-Communicating Hydrocephalus with Delirium Among Veterans
| Autor: | Rathnakara M Sherigar, Mark B. Detweiler, Naciye Kalafat, Brian Lutgens, Geoffrey Bader, Kelly Sullivan, Pavan Reddy, Arline Kenneth |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Internal capsule Temporal lobe 03 medical and health sciences 0302 clinical medicine Atrophy Internal medicine Cerebellum Parietal Lobe mental disorders medicine Humans 030212 general & internal medicine Veterans Affairs Aged Retrospective Studies Veterans Cerebral atrophy Brain Diseases business.industry Calcinosis Delirium General Medicine Middle Aged medicine.disease White Matter Hyperintensity nervous system diseases Hydrocephalus Case-Control Studies Cardiology Female medicine.symptom business Tomography X-Ray Computed 030217 neurology & neurosurgery |
| Zdroj: | Southern medical journal. 110(6) |
| ISSN: | 1541-8243 |
| Popis: | Objectives The literature regarding the underlying neuropathogenesis of delirium on head computed tomography (CT) is limited. The aim of this research was to investigate, using case-control retrospective chart review, the association of white matter lesions (WML), cerebral atrophy, intracranial extravascular calcifications, and ventricular-communicating hydrocephalus in older adult military veterans with and without delirium hospitalized in a Veterans Affairs Medical Center. Methods Head CT scans were examined for WML, atrophy, and intracranial extravascular calcifications globally in the cortex, subcortex (frontal, temporal, parietal, occipital lobes), basal ganglia (globus pallidus, caudate, putamen), and internal capsule, in addition to the presence of ventricular-communicating hydrocephalus. WML were graded as not present, 2 cm. Atrophy, cerebral atrophy, intracranial extravascular calcifications, and ventricular-communicating hydrocephalus were graded as present or not present. Results There was a significant association of WML in the temporal lobe periventricular cortical and subcortical brain and a significant association of atrophy in the parietal lobes and the cerebellum in hospitalized older adult military veterans with delirium compared with hospitalized older adult military veterans without delirium. There were no differences between the delirium and nondelirium groups for intracranial extravascular calcifications and ventricular-communicating hydrocephalus. Conclusions The results suggest that atrophy in the parietal lobes and the cerebellum of hospitalized older adult military veterans may be associated with an elevated risk of delirium when compared with age, race, and sex-matched control veterans. Continuing efforts are needed to clarify the role of atrophy during delirium in the veteran and nonveteran older adult population to reduce progressive frailty and decreased quality of life secondary to hospital and posthospital-discharge delirium. |
| Databáze: | OpenAIRE |
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