Akut posterior serebral arter infarktına bağlı bir deliryum olgusu

Deliryum, akut başlayan ve dalgalı bir seyir izleyen global mental durum bozukluğu ve dikkat eksikliği ile karakterize bir sendromdur. Deliryum, genellikle yaşlı hastalarda ortaya çıkar. Deliryum, herhangi bir non-spesifik akut inmenin sonucu oluşabilir. Seyrek olarak spesifik inmeye bağlı da gelişebilir. Literatürde az sayıda posterior serebral arter (PSA) infarktlarına bağlı deliryum tablosu bildirilmiştir. Elli sekiz yaşındaki kadın hasta, GİS kanaması ile Acil servise getirildi. Başvuruda, hastanın tansiyon arteryalinin (TA); 90/60mmHg, nabız hızının (N);100/dk, ateşinin (A);36,7oC ve nörolojik muayene bulgularının normal olduğu anlaşıldı. Başvurudaki anormal laboratuar bulguları; Hb;3.5g/dl, Htc;%9.8, BUN;68mg/dl, kreatinin;2.0mg/dl, glukoz;226mg/dl idi. Hb, 36 saat sonunda 8.5gr/dl düzeyine çıkarken başvurunun 48. saatinde hastada, deliryumun eşlik ettiği akut inme tablosu gelişti. Bu tablonun 14. saatinde bilgisayarlı beyin tomografisi sağ PSA alanında subakut aşamada iskemik infarkt bulgularını gösterdi. Hastaneye kabulünün beşinci gününde deliryum tablosu düzeldi. Bu yazıda akut iskemik inmeye (sağ PSA infarktı) bağlı deliryum tartışıldı

A case of delirium secondary to acute posterior cerebral artery infarction

Delirium is a syndrome characterized by an acute global mental disorder, fluctuating course, and abnormal attention. The most of patients with delirium are elderly. So many pathologic conditions may cause to delirium. Any acute stroke can lead to delirium. Nevertheless delirium can rarely result from spesific stroke including the infarct of the right posterior cerebral artery (r-PCA). Delirium is rarely reported in the course of the infarcts of the r-PCA in literature. A 58-year-old women admitted to ED with the GIS hemorrhage. On admission, the patient's arterial pressure (AP) was 90/60mmHg, and she had the neurologic examination findings. The pathologic laboratory findings included: ; Hb;3.5g/dl, Htc;%9.8, BUN;68mg/dl, creatinin;2.0mg/dl, glucose;226mg/dl. At 36 hours after admission, her Hb was 8.5gr/dl. At 48 hours after admission, the picture of acute stroke with delirium developed in patient. The cranial computed tomography showed the ischemic infarct in the distribution of r-PCA. On fifth day after admission, her delirium picture was recovered. In this report, the delirium depended on an acute ischemic stroke was discussed.

Kaynakça

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