![]() Patients usually present with impaired cognition, gait disturbance, and urinary incontinence that progressively worsen over three or more months.Ĭomputed tomography scanning will show ventriculomegaly, but the diagnosis should be pursued in patients with suspicious clinical findings, such as impaired executive thinking and memory. Normal pressure hydrocephalus has an average age of onset of 70 years, and its incidence increases after age 80. Patients on anticoagulant or antiplatelet agents can have spontaneous bleeding events and may not report a history of trauma.Ī neurosurgeon should be consulted if a subdural bleed is identified in the ED. Although these events can present in the acute stage (< 3 days), many geriatric patients present to the ED with subacute subdural hematomas (4-20 days). ![]() Families may report a minor fall and a slow cognitive decline over several days. Older adults who have a history of a recent fall, or who use anticoagulants and present to the ED with confusion, should be evaluated for the possibility of a subdural hematoma. They must be included on the differential diagnosis of any geriatric patient presenting to the ED for confusion many strokes are amenable to reperfusion therapy and endovascular intervention if identified quickly. Most strokes do not impact a patient's LOC or mental state however, some strokes can alter both. It is often mistaken for dementia.Ĭlinicians should use validated screening tools to evaluate patients, which may help investigate delirium in a systematic way. Delirium is easier to recognize in patients who become hyperactive "quiet" delirium may be more difficult to identify. Inattention is the hallmark sign/symptom. Patients' conditions can range from sleepy to agitated and combative. It presents as an acute change in consciousness and loss of cognition that waxes and wanes. ![]() ![]() Common causes of altered mental status in the elderly Delirium occurs in 7%-10% of geriatric patients in the emergency department (ED). Altered mental status is a broad category applied to geriatric patients with a change in cognition or level of consciousness (LOC) – delirium, agitation, coma, stupor. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |