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Delirium (formerly acute confusional state, an ambiguous term which is now discouraged) [1] is a specific state of acute confusion attributable to the direct physiological consequence of a medical condition, effects of a psychoactive substance, or multiple causes, which usually develops over the course of hours to days.
The underlying etiology of primary NPH has not yet been identified. Primary NPH affects adults age 40 years or older, most commonly in adults over 60. [15] Secondary NPH can affect persons of any age and occurs due to conditions such as subarachnoid hemorrhage, meningitis, brain surgery, brain radiation, or traumatic brain injury. [16]
Elderly people are more likely to experience confusion or problems with thinking following surgery, which can occur up to several days postoperatively. These cognitive problems can last for weeks or months, and can affect the patients’ ability to plan, focus, remember, or undertake activities of daily living.
This typically causes increased pressure inside the skull. Older people may have headaches, double vision, poor balance, urinary incontinence, personality changes, or mental impairment. In babies, it may be seen as a rapid increase in head size. Other symptoms may include vomiting, sleepiness, seizures, and downward pointing of the eyes. [1]
Initial orthostatic hypotension is frequently characterized by a systolic blood pressure decrease of ≥40 mmHg or diastolic blood pressure decrease of ≥20 mmHg within 15 seconds of standing. [32] Blood pressure then spontaneously and rapidly returns to normal, so the period of hypotension and symptoms is short (<30 s). [ 32 ]
PRES usually has an acute onset. Most people with PRES experience headaches and seizures; many also experience visual changes, confusion, drowsiness, weakness of the arm and/or leg on one side of the body (hemiplegia), difficulty speaking, or, more rarely, other neurological symptoms. Some people with PRES may experience coma. [2]
A small percentage of people may require surgery to relieve the pressure. [2] About 2 per 100,000 people are newly affected per year. [4] The condition most commonly affects women aged 20–50. [2] Women are affected about 20 times more often than men. [2] The condition was first described in 1897. [1]
Hypertensive encephalopathy (HE) is general brain dysfunction due to significantly high blood pressure. [3] Symptoms may include headache, vomiting, trouble with balance, and confusion. [1] Onset is generally sudden. [1] Complications can include seizures, posterior reversible encephalopathy syndrome, and bleeding in the back of the eye. [1] [3]
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