Delirium Without Focal Signs Related to a Thalamic Stroke

This case report described an 86-year-old man who developed delirium as the sole symptom of a thalamic intraparenchymal hemorrhage, a rare presentation for stroke. Despite initial treatment for urinary tract and gastrointestinal infections, his delirium persisted until a CT scan revealed the hemorrhage. The patient's delirium gradually resolved after stopping anticoagulation therapy, but he experienced a significant cognitive decline, with his MMSE score dropping from 26 to 11. The study highlighted that delirium can occur in 13%-48% of stroke patients, particularly in older individuals and those with hemorrhagic or thalamic strokes, and emphasized the importance of considering acute stroke in the differential diagnosis of delirium, even in the absence of focal neurological signs.