What is the treatment for post stroke delerium?

Jainnagraj asked...

My wife had hemiparesis as a result of stroke due to blocked artery in brain. She could not walk. After about a weeks treatment in hospital and six months treatment at home she started walking. But after six months of stroke she had mental problems like forgetting due probably to impairment of temporary memory. Doctor gave treatment for depression. But no improvement. Now it is thought to be vascular dementia . Here also no effective treatment with medicine. I personally feel that it must be Delirium post stroke. I would like to know treatment for this.

Expert Answer

James Castle, M.D. is a neurologist at NorthShore University HealthSystem (affiliated with The University of Chicago) and an expert on strokes.

It does sound very suspicious for post-stroke dementia. Delerium would imply that this is a temporary, reversible issue, which it does not sound like since it has been going on for such a long time. However, I think it is very important to make sure there is no underlying cause for delerium - lab testing of electrolytes, liver and kidney function, blood counts, thyroid function, vitamin B12 level, and urine for evidence of infection are all important. I would also review her medications with her doctor to make sure that none of them are causing a delerium.

If all of that appears unremarkable, consider having her doctor start her on a cognitive enhancing medication like donepezil. I have had quite a lot of success treating post-stroke dementia with this medication.

Good luck!