Acute confusional states secondary to infarctions in the territory of the posterior cerebral artery in elderly patients.

Acute confusional states and agitated delirium are among the most common psychopathologic disorders in the elderly. However, they are rarely reported in the course of infarcts in the territory of the posterior cerebral artery. This study involving thirteen patients aged more than 65 years suggests that acute confusional states from posterior cerebral artery infarcts are less rare than usually thought, although the diagnosis may be difficult during the acute phase. The risk factors are no different from those observed for infarcts in other cortical areas, suggesting that this syndrome is due to structural damage of the brain rather than the other, usual causes of confusion in the elderly (intoxications, dysmetabolic diseases or dementia). The recognition of acute confusional states from posterior cerebral artery infarcts and its distinction from other causes of confusion is important in elderly patients because of the different diagnostic, prognostic and therapeutic implications involved.