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Micturitional disturbance in a patient with a spinal cavernous angioma
Author(s) -
Sakakibara Ryuji,
Uchiyama Tomoyuki,
Yoshiyama Mitsuharu,
Aotsuka Akiyo,
Mori Masahiro,
Kanesaka Toshihide,
Hattori Takamichi,
Yamanishi Tomonori
Publication year - 2003
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.10039
Subject(s) - medicine , dyssynergia , urinary retention , urination , hyperreflexia , surgery , urethral sphincter , spinal cord , angioma , myelopathy , sphincter , urinary incontinence , anesthesia , urinary system , anatomy , vascular disease , psychiatry
A 58‐year‐old woman had a 3‐year history of numbness in the right leg, which developed into thoracic transverse myelopathy and urinary retention. After referral to our department, MRI scans revealed a lesion with a target appearance at the T10–11 spinal cord with multiple silent cerebral lesions, which confirmed the diagnosis of cavernous angioma. Gamma‐knife surgery was not indicated, considering the risk of adverse effects. The patient gradually became able to urinate, but had urge urinary incontinence. The first urodynamic studies (conducted 3 months after full clinical manifestations of transverse myelopathy) showed detrusor hyperreflexia (DH), decreased bladder sensation during bladder filling, detrusor‐sphincter dyssynergia (DSD), and weak detrusor on voiding. However, urinary retention appeared again without change of neurologic signs. The second urodynamic studies (conducted 2 months later) showed less marked DH during bladder filling, and equivocal DSD but marked weak detrusor on voiding. The patient started taking oral prazosin hydrochloride (6 mg/day), which gradually ameliorated her voiding difficulty. Lesions in the lateral and dorsal columns of the spinal cord seem to be responsible for the micturitional disturbance in our patient with spinal cavernous angioma. Neurourol. Urodynam. 22:606–610, 2003. © 2003 Wiley‐Liss, Inc.