Welcome to the WSC 2021 Interactive Program

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Delirium is a neuropsychiatric condition that is commonly seen in the context of acute illness. The syndrome can present in various ways but is generally characterised by an acute change in cognitive state with predominant attentional deficits. Recent studies have suggested that delirium occurs in around one in four patients during their time in an acute stroke unit. This number may be an under-estimate as delirium can be easily missed in a person with severe stroke who is medically unwell. The importance of recognising delirium is because of its association with poor outcomes. Stroke associated with delirium is more likely to result in death, institutionalisation and future dementia.

Despite its prevalence and importance, delirium has received less attention in research and guidelines than other post-stroke complications. Thankfully this situation is now changing and important delirium in stroke research is improving our understanding and management of the syndrome. In this plenary session, Dr Terry Quinn (University of Glasgow, UK) will consider the epidemiology of delirium in stroke, then discuss the assessment and management. He will draw upon the most recent research describing delirium in stroke and the evidence base that informs delirium care in other critical illness conditions. Throughout his talk he will emphasise that delirium is an important consideration for anyone working in stroke, that good quality delirium management can be delivered as part of standard stroke unit care and he will highlight the importance of delirium prevention.

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The aim of this lecture is to update the audience on the most common neuropsychiatric disorders after stroke, namely poststroke depression, apathy and anxiety, which affect more than 1/3 of stroke survivors. We will detail the epidemiological and clinical features of these disturbances, and describe available screening instruments and DSM V diagnostic criteria. Recent advances on pathophysiology will be discussed, based on neuroimaging mapping of stroke lesions and functional MR studies. Recent evidence on the management of depression, apathy and anxiety will be reviewed. Depression, apathy and anxiety may persist despite best available management and may relapse. These neuropsychiatric disturbance have a negative impact on the rehabilitation and Quality of Life of persons who survived an acute stroke