Acute Confusion - Explore the Science & Experts | ideXlab

Scan Science and Technology

Contact Leading Edge Experts & Companies

Acute Confusion

The Experts below are selected from a list of 315 Experts worldwide ranked by ideXlab platform

Acute Confusion – Free Register to Access Experts & Abstracts

Mark Sherer – One of the best experts on this subject based on the ideXlab platform.

  • prospective comparison of Acute Confusion severity with duration of post traumatic amnesia in predicting employment outcome after traumatic brain injury
    Journal of Neurology Neurosurgery and Psychiatry, 2007
    Co-Authors: Risa Nakaserichardson, Stuart A. Yablon, Mark Sherer
    Abstract:

    Background: Measurement of the duration of post-traumatic amnesia (PTA) is common practice, serving as an important index of the severity of traumatic brain injury (TBI) and a predictor of functional outcome. However, controversy exists regarding the nature of PTA; some studies indicate that it is a Confusional state with symptoms that extend beyond disorientation and amnesia. Objective: To evaluate the contribution of the severity of Acute Confusion 1 month after TBI to prediction of employment at 1 year after injury, comparing it with PTA duration. Methods: Prospective study involving 171 participants with complete data, who met the study criteria, from 228 consecutive TBI Model System admissions. Outcome measures included weekly administration of the Delirium Rating Scale-Revised-98 (DelRS-R98) to measure the severity of Acute Confusion. Evaluations closest to 1 month after injury were used for study purposes. Duration of PTA was defined as the interval from injury until two consecutive Galveston Orientation and Amnesia Test scores of ⩾76 were obtained within a period of 24–72 h. Univariable and multivariable logistic regression were used to predict employment status at 1 year after injury. Results: Age, education and DelRS-R98 were significant predictors accounting for 34% of outcome variance. Individuals with greater Confusion severity at 1 month after injury, older age and lower levels of education were less likely to be employed at 1 year after injury. Severity of Confusion was more strongly associated with employment outcome (r s  = −0.39) than was PTA duration (r s  = −0.34). Conclusions: In addition to demographic indices, severity of Acute Confusion makes a unique contribution to predicting late outcome after TBI.

  • multidimensional assessment of Acute Confusion after traumatic brain injury
    Archives of Physical Medicine and Rehabilitation, 2005
    Co-Authors: Mark Sherer, Stuart A. Yablon, Risa Nakasethompson, Samuel T Gontkovsky
    Abstract:

    Abstract Sherer M, Nakase-Thompson R, Yablon SA, Gontkovsky ST. Multidimensional assessment of Acute Confusion after traumatic brain injury. Objectives To describe the phenomenology of posttraumatic Confusional state (PTCS) and to provide preliminary validation of a new procedure, the Confusion Assessment Protocol (CAP), for assessing PTCS. Design Criterion standard investigation. Setting Inpatient traumatic brain injury (TBI) rehabilitation program. Participants Two consecutive series of patients (n=62, n=93) with TBI admitted for inpatient rehabilitation. Interventions Not applicable. Main outcome measures Clinical diagnosis of delirium based on Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria, classification of posttraumatic amnesia (PTA) based on the Galveston Orientation and Amnesia Test (GOAT), and Disability Rating Scale score at time of rehabilitation hospital discharge. Results Agreement between the diagnosis of PTCS with the CAP and DSM-IV classification of delirium was 87%, and agreement between PTCS and PTA using GOAT criteria was 90%. Patients classified as in PTCS sustained more severe injuries and required longer rehabilitation stays. Confusion status was associated with poorer functional status at rehabilitation discharge. Conclusions The CAP is a brief, structured, repeatable measure of multiple neurobehavioral aspects of PTCS. Confusion status as determined by CAP assessment contributed to prediction of outcome at rehabilitation discharge after adjustment for other potential predictors.

  • Acute Confusion following traumatic brain injury
    Brain injury, 2004
    Co-Authors: Risa Nakase-thompson, Mark Sherer, Stuart A. Yablon, Todd G. Nick, Paula T. Trzepacz
    Abstract:

    Primary objective: To determine the incidence, duration and symptoms associated with Acute Confusion/delirium among traumatic brain injury (TBI) neuro-rehabilitation admissions.Research design: Prospective evaluation of neurobehavioural impairments following TBI among inpatient neurorehabilitation admissions.Methods and procedures: Eighty-five consecutive TBI model system patients were evaluated using measures of orientation, cognition, motor restlessness and delirium.Main outcomes and results: Fifty-nine individuals met Diagnostic and Statistical Manual of Mental Disorders—Fourth Edition Delirium Diagnostic Criteria (DDC) on initial evaluation and 42 of these resolved delirium during inpatient rehabilitation. Multivariable logistic regression analyses revealed significant unique associations of the Galveston Orientation and Amnesia Test (GOAT), Delirium Rating Scale, Cognitive Test for Delirium and time elapsed since injury with DDC status.Conclusions: Findings indicate that delirium is common among neur…

Stuart A. Yablon – One of the best experts on this subject based on the ideXlab platform.

  • prospective comparison of Acute Confusion severity with duration of post traumatic amnesia in predicting employment outcome after traumatic brain injury
    Journal of Neurology Neurosurgery and Psychiatry, 2007
    Co-Authors: Risa Nakaserichardson, Stuart A. Yablon, Mark Sherer
    Abstract:

    Background: Measurement of the duration of post-traumatic amnesia (PTA) is common practice, serving as an important index of the severity of traumatic brain injury (TBI) and a predictor of functional outcome. However, controversy exists regarding the nature of PTA; some studies indicate that it is a Confusional state with symptoms that extend beyond disorientation and amnesia. Objective: To evaluate the contribution of the severity of Acute Confusion 1 month after TBI to prediction of employment at 1 year after injury, comparing it with PTA duration. Methods: Prospective study involving 171 participants with complete data, who met the study criteria, from 228 consecutive TBI Model System admissions. Outcome measures included weekly administration of the Delirium Rating Scale-Revised-98 (DelRS-R98) to measure the severity of Acute Confusion. Evaluations closest to 1 month after injury were used for study purposes. Duration of PTA was defined as the interval from injury until two consecutive Galveston Orientation and Amnesia Test scores of ⩾76 were obtained within a period of 24–72 h. Univariable and multivariable logistic regression were used to predict employment status at 1 year after injury. Results: Age, education and DelRS-R98 were significant predictors accounting for 34% of outcome variance. Individuals with greater Confusion severity at 1 month after injury, older age and lower levels of education were less likely to be employed at 1 year after injury. Severity of Confusion was more strongly associated with employment outcome (r s  = −0.39) than was PTA duration (r s  = −0.34). Conclusions: In addition to demographic indices, severity of Acute Confusion makes a unique contribution to predicting late outcome after TBI.

  • multidimensional assessment of Acute Confusion after traumatic brain injury
    Archives of Physical Medicine and Rehabilitation, 2005
    Co-Authors: Mark Sherer, Stuart A. Yablon, Risa Nakasethompson, Samuel T Gontkovsky
    Abstract:

    Abstract Sherer M, Nakase-Thompson R, Yablon SA, Gontkovsky ST. Multidimensional assessment of Acute Confusion after traumatic brain injury. Objectives To describe the phenomenology of posttraumatic Confusional state (PTCS) and to provide preliminary validation of a new procedure, the Confusion Assessment Protocol (CAP), for assessing PTCS. Design Criterion standard investigation. Setting Inpatient traumatic brain injury (TBI) rehabilitation program. Participants Two consecutive series of patients (n=62, n=93) with TBI admitted for inpatient rehabilitation. Interventions Not applicable. Main outcome measures Clinical diagnosis of delirium based on Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria, classification of posttraumatic amnesia (PTA) based on the Galveston Orientation and Amnesia Test (GOAT), and Disability Rating Scale score at time of rehabilitation hospital discharge. Results Agreement between the diagnosis of PTCS with the CAP and DSM-IV classification of delirium was 87%, and agreement between PTCS and PTA using GOAT criteria was 90%. Patients classified as in PTCS sustained more severe injuries and required longer rehabilitation stays. Confusion status was associated with poorer functional status at rehabilitation discharge. Conclusions The CAP is a brief, structured, repeatable measure of multiple neurobehavioral aspects of PTCS. Confusion status as determined by CAP assessment contributed to prediction of outcome at rehabilitation discharge after adjustment for other potential predictors.

  • Acute Confusion following traumatic brain injury
    Brain injury, 2004
    Co-Authors: Risa Nakase-thompson, Mark Sherer, Stuart A. Yablon, Todd G. Nick, Paula T. Trzepacz
    Abstract:

    Primary objective: To determine the incidence, duration and symptoms associated with Acute Confusion/delirium among traumatic brain injury (TBI) neuro-rehabilitation admissions.Research design: Prospective evaluation of neurobehavioural impairments following TBI among inpatient neurorehabilitation admissions.Methods and procedures: Eighty-five consecutive TBI model system patients were evaluated using measures of orientation, cognition, motor restlessness and delirium.Main outcomes and results: Fifty-nine individuals met Diagnostic and Statistical Manual of Mental Disorders—Fourth Edition Delirium Diagnostic Criteria (DDC) on initial evaluation and 42 of these resolved delirium during inpatient rehabilitation. Multivariable logistic regression analyses revealed significant unique associations of the Galveston Orientation and Amnesia Test (GOAT), Delirium Rating Scale, Cognitive Test for Delirium and time elapsed since injury with DDC status.Conclusions: Findings indicate that delirium is common among neur…

Jose Biller – One of the best experts on this subject based on the ideXlab platform.

  • do not forget susac syndrome in patients with unexplained Acute Confusion
    Journal of Stroke & Cerebrovascular Diseases, 2015
    Co-Authors: Michael Star, Rick Gill, Maria Bruzzone, Felipe De Alba, Michael J Schneck, Jose Biller
    Abstract:

    Background To report 2 patients with Susac syndrome presenting with Acute Confusion and abnormal neuroimaging and cerebrospinal fluid (CSF) findings, both of whom were initially misdiagnosed. Susac syndrome is a rare, though likely underdiagnosed, endotheliopathy defined clinically by the triad of encephalopathy, branch retinal artery occlusions (BRAOs), and sensorineural hearing loss (SNHL). Its pathogenesis remains poorly understood. The classic clinical triad may not be fully developed at initial presentation, even at the time magnetic resonance imaging (MRI) demonstrates characteristic central corpus callosum lesions. Methods We describe the patient’s clinical course, investigations, management, and follow-up. Results A 57-year-old woman had Acute onset of Confusion and was initially thought to have multiple strokes. MRI demonstrated restricted diffusion involving the splenium of the corpus callosum and CSF showed elevated protein levels. Audiometry showed asymmetric bilateral SNHL. Fluorescein angiography showed multiple bilateral BRAOs. Patient received corticosteroids and intravenous immunoglobulin (IVIG). At 1-month follow-up, patient’s Confusion had resolved. The second patient was a 32-year-old man who had Acute onset of Confusion. CSF demonstrated pleocytosis and elevated protein. MRI demonstrated restricted diffusion involving the corpus callosum. Patient was discharged and rehospitalized 20 days later where he was diagnosed with Acute disseminated encephalomyelitis. Patient presented a third time with vision loss. Fluorescein angiography demonstrated bilateral BRAOs. Audiometry noted bilateral SNHL. He received IVIG and discharged on a prednisone taper and mycophenolate mofetil. At 1-month follow-up, patient’s Confusion had resolved. Conclusions We report 2 patients evaluated within 1 month of each other who presented with Acute Confusion and were eventually diagnosed with Susac syndrome. Susac syndrome should be considered in young patients with otherwise unexplained Acute onset of Confusion with MRI and CSF changes as described previously.

  • do not forget susac syndrome in patients with unexplained Acute Confusion p6 303
    Neurology, 2014
    Co-Authors: Michael Star, Rick Gill, Maria Bruzzone, Felipe De Alba, Michael J Schneck, Jose Biller
    Abstract:

    OBJECTIVE: To report two patients with Susac syndrome presenting with Acute Confusion and abnormal neuroimaging and cerebrospinal fluid (CSF) findings, both of whom were initially misdiagnosed. BACKGROUND: Susac syndrome is an unusual autoimmune endotheliopathy clinically characterized by the triad of encephalopathy, branch retinal artery occlusions (BRAOs), and sensorineural hearing loss (SNHL). Its pathogenesis remains poorly understood. The classic clinical triad may not be fully developed at initial presentation, even at the time MRI demonstrates characteristic central corpus callosum lesions. DESIGN/METHODS: We describe their clinical course, investigations, management, and follow-up. RESULTS: A 57-year-old woman had Acute onset of Confusion and was initially thought to have multiple strokes. MRI demonstrated restricted diffusion involving the splenium of the corpus callosum. CSF showed a protein level of 164mg/dl and 8 white blood cells (79% lymphocytes). Audiology showed asymmetric bilateral SNHL. Fluorescein angiography (FA) showed multiple bilateral BRAOs. Patient received corticosteroids and IVIG. At one month follow up, patient’s Confusion had resolved. The second patient was a 32-year-old man who had Acute onset of Confusion. CSF demonstrated 24 white blood cells (87% lymphocytes) and a protein level of 234mg/dl. MRI demonstrated restricted diffusion involving the corpus callosum. Patient was discharged and re-hospitalized twenty days later where he was diagnosed with Acute disseminated encephalomyelitis. Patient presented a third time with vision loss. FA demonstrated bilateral BRAOs. Audiology noted bilateral SNHL. He received IVIG and discharged on a prednisone taper and mycophenolate mofetil. At one month follow-up, patient’s Confusion had resolved. CONCLUSIONS: We report two patients evaluated within one month of each other who presented with Acute Confusion associated with MRI and CSF abnormalities and were eventually diagnosed with Susac syndrome. Susac syndrome remains under-diagnosed and should be included in the differential diagnosis of patients with unexplained Confusional state associated with CSF pleocytosis/proteinorrachia and MRI callosal abnormalities. Disclosure: Dr. Star has nothing to disclose. Dr. Bruzzone has nothing to disclose. Dr. De Alba has nothing to disclose. Dr. Gill has nothing to disclose. Dr. Schneck has received personal compensation in an editorial capacity for eMedicine. Dr. Schneck has received research support from NIH and Lundbeck. Dr. Biller has received personal compensation in an editorial capacity for the Journal of Stroke and Cerebrovascular Diseases and Frontiers in Neurology.