Neuroanatomical correlation of urinary retention in lateral medullary infarction

Cho, Han-Jin; Kang, Tae Seok; Chang, Jae-Hyeok; Choi, Yuri; Park, Min-Gyu; Choi, Kwang-Dong; Sung, Sang-Min; Park, Kyung-Pil; Jung, Dae-Soo

doi:10.1002/ana.24379

Cited by 25 publications

(18 citation statements)

References 13 publications

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“…Although the neuroimaging study disclosed no abnormality in the brainstem, the blink reflex was abnormal, suggesting a brainstem dysfunction. Moreover, the clinical feature of sphincter disturbance observed in this case was similar to that of patients with lateral medullary infarction reported by Cho et al …”

Section: Discussionsupporting

confidence: 90%

A case of incomplete Miller Fisher syndrome associated with multiple cranial neuritis and sphincter disturbance

Hosokawa

Suzuki

Ono

et al. 2018

Neurology & Clinical Neurosc

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A 60-year-old man, following diarrhea for 2 weeks, acutely developed double vision, unsteady gait, and difficulty in urination, followed by severe dysphagia and bilateral peripheral facial palsy. In view of the preserved anal sphincter and bulbocavernosus reflexes, the sphincter disturbance was ascribed to a brainstem lesion. Serum antibodies against gangliosides including GQ1b were negative. With the clinical diagnosis of incomplete Miller Fisher syndrome combined with multiple cranial neuritis and a possible brainstem lesion, the patient was treated with intravenous immunoglobulin, and most symptoms have improved.

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Section: Discussionsupporting

confidence: 90%

A case of incomplete Miller Fisher syndrome associated with multiple cranial neuritis and sphincter disturbance

Hosokawa

Suzuki

Ono

et al. 2018

Neurology & Clinical Neurosc

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“…Other investigated stroke areas (thalamus, cerebellum, and pons) have been shown to be activated during the micturition phase in PET and fMRI studies [2,3,6,7], and there have been some reported cases of strokes in these areas causing urinary retention [12,13]. Descending pathways of the PMC, including the medulla, have also been associated with voiding function [14], but in our study these areas were not associated with urinary retention. The role of these areas is probably minor in the vast network of urinary control, and damage to these regions may be a risk factor for urinary retention, which may result when patients with strokes in these areas have prostatic hyperatrophy or infections that are further risk factors.…”

Section: Discussioncontrasting

confidence: 50%

Urinary Retention Associated with Stroke

Umemura

Ohta²,

Yokota³

et al. 2016

J UOEH

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Patients often exhibit urinary retention following a stroke. Various neuropathological and animal studies have implicated the medulla oblongata, pons, limbic system, frontal lobe as areas responsible for micturition control, although the exact area responsible for urinary retention after stroke is not clear. The purpose of this study was to identify the stroke area responsible for urinary retention by localizing the areas where strokes occur. We assessed 110 patients with cerebral infarction and 27 patients with cerebral hemorrhage (78 men, 59 women; mean age, 73.0 years) who had been admitted to our hospital between October, 2012 and September, 2013. We used computed tomography (CT) and magnetic resonance imaging (MRI) to investigate the stroke location, and evaluated whether post-stroke urinary retention occurred. Twelve (8.8%) of the 137 patients (7 men, 5 women; mean age, 78.8 years) exhibited urinary retention after a stroke. Stroke occurred in the right/left dominant hemisphere in 7 patients; nondominant hemisphere in 1; cerebellum in 3; and brainstem in 1. Strokes in the dominant hemisphere were associated with urinary retention (P = 0.0314), particularly in the area of the insula (P < 0.01). We concluded that stroke affecting the insula of the dominant hemisphere tends to cause urinary retention.

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“…The pontine micturition reflex is controlled by inhibitory input from the medial frontal lobe, cingulate gyrus, hypothalamus, and periaqueductal gray. 4 , 5 A lesion above the pontine micturition center may cause uninhibited overactivity of the bladder with urinary incontinence. 6 A lesion at the brainstem interrupts the descending pathway from the pontine micturition center and may cause an emptying disorder of the bladder, engendering urinary retention.…”

mentioning

confidence: 99%

Portable Bladder Ultrasound Reduces Incidence of Urinary Tract Infection and Shortens Hospital Length of Stay in Patients With Acute Ischemic Stroke

Chen

et al. 2018

J Cardiovasc Nurs

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Background:Urinary tract infection (UTI) during acute ischemic stroke is associated with a longer hospital length of stay and unfavorable functional outcomes.Objective:We investigated the benefits of portable bladder ultrasound (PBU) scanning during acute ischemic stroke.Methods:We retrospectively reviewed patients with acute ischemic stroke from January 2011 to February 2017. Patients were divided into group 1 (PBU not available) and group 2 (PBU available), before or after the split date, April 9, 2014. Portable bladder ultrasound scanning was conducted by nurses to measure postvoid residual urine volume in patients with impaired consciousness and/or dependent ambulation.Results:In total, 1928 patients were enrolled, of whom 109 (5.7%) had UTI and 901 (46.7%) experienced unfavorable outcomes (modified Rankin scale score ≥ 3). Multivariate analysis revealed that factors that influenced UTI were age of 75 years or older, female gender, initial total National Institutes of Health Stroke Scale (NIHSS) score of 5 or higher, initial NIHSS conscious score of 1 or higher, initial NIHSS leg score of 2 or higher, and urinary catheterization. Factors influencing unfavorable outcomes were similar to those influencing UTI but further comprised UTI. C-statistic for UTI detection was 0.864 for model fitting, including significant factors in logistic regression. Compared with group 1, group 2 had a higher incidence of urinary catheterization (13.1% vs 8.2%), a lower incidence of UTI (4.0% vs 6.9%), and a shorter length of stay (11.9 vs 13.6 days).Conclusions:Portable bladder ultrasound scanning reduced the incidence of UTI and shortened length of stay. We suggest routine PBU procedures for patients with acute ischemic stroke who fulfill the AGN3 criteria for a high risk of UTI.

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Neuroanatomical correlation of urinary retention in lateral medullary infarction

Cited by 25 publications

References 13 publications

A case of incomplete Miller Fisher syndrome associated with multiple cranial neuritis and sphincter disturbance

A case of incomplete Miller Fisher syndrome associated with multiple cranial neuritis and sphincter disturbance

Urinary Retention Associated with Stroke

Portable Bladder Ultrasound Reduces Incidence of Urinary Tract Infection and Shortens Hospital Length of Stay in Patients With Acute Ischemic Stroke

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