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To authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1552-6569.2008.00353.x Byline: Ji Man Hong (1), In Soo Joo (1), Kyoon Huh (1), Seung Soo Sheen (1) Keywords: Vasomotor reactivity; transcranial Doppler; middle cerebral artery; basilar artery Abstract: ABSTRACT BACKGROUND We assess the feasibility of using the newly designed suboccipital probe fixation device (SPFD) as a convenient and reliable tool for simultaneous measurement of vasomotor reactivity (VMR) in the middle cerebral artery (MCA) and basilar artery (BA). METHODS We analyzed 30 healthy volunteers' VMR values by using both SPFD and conventional handheld method. The VMR values were measured as percentage increase of the mean flow velocity on transcranial Doppler (TCD) in response to hypercapnia induced by the rebreathing method. The VMR tests were performed three times: (1) for both MCAs, (2) for the index MCA (the better signal window) and the BA by using the SPFD, and (3) for the index MCA and the BA by using the handheld technique. RESULTS The VMR values of the right and left MCAs were similar (P > .05). Although the VMR values of the index MCA and the BA obtained by SPFD application and the handheld technique were similar (P > .05), the correlation coefficient of VMR values obtained by using the SPFD was higher (r= .827, P < .001 vs. r= .568, P= .001). CONCLUSION The SPFD is a convenient and reliable tool for the evaluation of relative VMR between the MCA and BA during TCD monitoring. Author Affiliation: (1)From the Department of Neurology, Ajou University School of Medicine, Suwon-s?, kyunggi-do, South Korea (JMH, ISJ, KH); and Section of Clinical Epidemiology & Biostatistics, Regional Clinical Trial Center, Ajou University School of Medicine, Suwon-s?, kyunggi-do, South Korea (SSS). Article History: Acceptance: Received March 31, 2008, and in revised form November 20, 2008. Accepted for publication November 28, 2008. Article note: Correspondence: Address correspondence to Ji Man Hong, MD, PhD, Department of Neurology, Ajou University School of Medicine, 5 San, Woncheon-dong, Yongtong-gu, Suwon-s?, Kyunggi-do, 442-749, South Korea. E-mail: dacda@hanmail.net

Background: Post-stroke delirium is a common problem in the care of stroke patients, and is associated with longer hospitalization, high short-term mortality, and an increased need for long-term care. Although post-stroke delirium occurs in approximately 10 ~ 30% of patients, little is known about the risk factors for post-stroke delirium in patients who experience acute stroke.Methods: A total of 576 consecutive patients who experienced ischemic stroke (mean age, 65.2 years; range, 23-93 years) were screened for delirium over a 2-year period in an acute stroke care unit of a tertiary referral hospital. We screened for delirium using the Confusion Assessment Method. Once delirium was suspected, we evaluated the symptoms using the Korean Version of the Delirium Rating Scale-Revised-98. Neurological deficits were assessed using the National Institutes of Health Stroke Scale at admission and discharge, and functional ability was assessed using the Barthel Index and modified Rankin Scale at discharge and 3 months after discharge.Results: Thirty-eight (6.7%) patients with stroke developed delirium during admission to the acute stroke care unit. Patients with delirium were significantly older (70.6 vs. 64.9 years of age, P = .001) and smoked cigarettes more frequently (40% vs. 24%, P = .033) than patients without delirium. In terms of clinical features, the delirium group experienced a significantly higher rate of major hemispheric stroke (55% vs. 26%, P < .001), exhibited poorer functional performance at discharge and 3 months after discharge, and stayed in hospital significantly longer. Independent risk factors for delirium were older age, history of cigarette smoking, and major hemispheric stroke.Conclusion: Abrupt cessation of cigarette smoking may be a risk factor for post-stroke delirium in ischemic stroke patients. The development of delirium after stroke is associated with worse outcome and longer hospitalization. [ABSTRACT FROM AUTHOR]