Premium
Neurogenic Bladder Due to Hypoxic‐Ischemic Demyelination
Author(s) -
Ramchandren Sindhu,
Liebeskind David S.
Publication year - 2008
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/j.1552-6569.2007.00167.x
Subject(s) - medicine , wallerian degeneration , white matter , spinal cord , pathology , ischemia , multiple sclerosis , magnetic resonance imaging , hypoxia (environmental) , radiology , cardiology , immunology , chemistry , organic chemistry , psychiatry , oxygen
BACKGROUND AND PURPOSE Hypoxia is commonly known to target neuronal cell bodies. Although myelin is a non‐infrequent target, posthypoxic demyelination is a rarely described entity. We describe the case of a man who developed neurogenic bladder following a motor vehicle accident.CASE REPORT Following a severe motor‐vehicle accident involving massive blood loss, a 46‐year‐old man developed urinary urgency requiring catheterization, with hyperactive reflexes and bilateral Babinski signs on exam.RESULTS Magnetic resonance imaging of the brain and cervical cord revealed diffuse, isolated white matter signal abnormality in a symmetric, confluent distribution, extending inferiorly into the spinal cord, with changes consistent with bilateral Wallerian degeneration. Serologic and CSF evaluations were normal.CONCLUSIONS Unlike previous reports of hypoxic‐ischemic demyelination, our patient lacked any cortical abnormalities, presumably due to isolated white matter changes. This report alerts physicians to the possibility of hypoxic‐ischemic demyelination due to global hypoxia‐ischemia as an etiologic factor for neurogenic bladder.