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Neurocrit Care. Author manuscript; available in PMC 2017 June 01. Published in final edited form as: Neurocrit Care. 2016 June ; 24(3): 397–403. doi:10.1007/s12028-015-0210-1.

Hematoma Locations Predicting Delirium Symptoms After Intracerebral Hemorrhage Andrew M. Naidech, MD, MSPH1,2, Kelly L. Polnaszek, BS2, Michael D. Berman, BA1,2, and Joel L. Voss, PhD1,2 1Ken

& Ruth Davee Department of Neurology, 303 East Chicago Ave, Ward 12-140, Chicago, IL, USA 60611

Author Manuscript

2Department

of Medical Social Sciences, 303 East Chicago Ave, Ward 19th Floor, Chicago, IL,

USA 60611

Abstract Background—Delirium symptoms are associated with later worse functional outcomes and long-term cognitive impairments, but the neuroanatomical basis for delirium symptoms in patients with acute brain injury is currently uncertain. We tested the hypothesis that hematoma location is predictive of delirium symptoms in patients with intracerebral hemorrhage, a model disease where patients are typically not sedated or bacteremic.

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Methods—We prospectively identified 90 patients with intracerebral hemorrhage who underwent routine twice-daily screening for delirium symptoms with a validated examination. Voxel-based lesion-symptom mapping with acute computed tomography was used to identify hematoma locations associated with delirium symptoms (N=89). Results—Acute delirium symptoms were predicted by hematoma of right-hemisphere subcortical white matter (superior longitudinal fasciculus) and parahippocampal gyrus. Hematoma including these locations had an odds ratio for delirium of 13 (95%CI 3.9–43.3, P