ACR Appropriateness Criteria® Acute Mental Status Change, Delirium, and New Onset Psychosis

Publication date: May 2019Source: Journal of the American College of Radiology, Volume 16, Issue 5, SupplementAuthor(s): Expert Panel on Neurological Imaging:, Michael D. Luttrull, Daniel J. Boulter, Claudia F.E. Kirsch, Joseph M. Aulino, Joshua S. Broder, Santanu Chakraborty, Asim F. Choudhri, Andrew F. Ducruet, A. Tuba Kendi, Ryan K. Lee, David S. Liebeskind, William Mack, Toshio Moritani, Robert P. Roca, Lubdha M. Shah, Aseem Sharma, Robert Y. Shih, Sophia C. Symko, Julie BykowskiAbstractAcute changes in mental status represent a broad collection of symptoms used to describe disorders in mentation and level of arousal, including the more narrowly defined diagnoses of delirium and psychosis. A wide range of precipitating factors may be responsible for symptom onset including infection, intoxication, and metabolic disorders. Neurologic causes that may be detected on neuroimaging include stroke, traumatic brain injury, nonconvulsive seizure, central nervous system infection, tumors, hydrocephalus, and inflammatory disorders. Not infrequently, two or more precipitating factors may be found. Neuroimaging with CT or MRI is usually appropriate if the clinical suspicion for an acute neurological cause is high, where the cause of symptoms is not found on initial assessment, and for patients whose symptoms do not respond appropriately to management. There was disagreement regarding the appropriateness of neuroimaging in cases where a suspected, nonneurologic cause is found on initia...
Source: Journal of the American College of Radiology - Category: Radiology Source Type: research