Micturitional disturbance and the pontine tegmental lesion: Urodynamic and MRI analyses of vascular cases
Micturitional disturbance and the pontine tegmental lesion: Urodynamic and MRI analyses of vascular cases
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DOI：
10.1016/0022-510x(96)00079-2
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发表时间：
1996-09-15
影响因子：
4.4
通讯作者：
Yamanishi, T
中科院分区：
文献类型：
--
作者：
Sakakibara, R;Hattori, T;Yamanishi, T
记录了39例急性脑干卒中患者的排尿史。在发病后3个月内，49%有刺激性和阻塞性泌尿系统症状，最常见的是排尿困难和夜间尿频，占28%，其次是尿潴留，占21%。对11例有症状的患者进行尿动力学检查，发现73%的患者逼尿肌反射亢进，9%的患者膀胱顺应性降低，27%的患者无张力膀胱测压，45%的患者逼尿肌-括约肌协同失调，27%的患者无抑制性括约肌松弛。3例无症状患者尿动力学检查结果正常。有症状患者的脑磁共振图像主要集中在脑桥网状核、臂旁内侧核旁网状结构和蓝斑核的背外侧区。这些区域似乎是主要负责核上型的骨盆和阴部神经功能障碍，在我们的脑干中风患者，相应的脑桥尿储存和排尿中心在动物研究中报告。
Micturitional histories were taken from 39 patients with acute brainstem stroke. Within 3 months from onset, 49% had irritative as well as obstructive urinary symptoms, the most common being voiding difficulty and nocturnal urinary frequency in 28%, followed by urinary retention in 21%. Urodynamic studies of 11 symptomatic patients revealed detrusor hyperreflexia in 73%, low compliance bladder in 9%, atonic cystometrogram in 27%, detrusor-sphincter dyssynergia in 45% and uninhibited sphincter relaxation in 27%. Three asymptomatic patients had normal urodynamic findings. Brain magnetic resonance images of the lesions of the symptomatic patients were concentrated in the dorsolateral pens including pontine reticular nucleus and the reticular formation adjacent to the medial parabrachial nucleus and the locus coeruleus. These regions seem to be mainly responsible for supranuclear types of pelvic and pudendal nerve dysfunction in our patients with brainstem stroke, corresponding to the pontine urinary storage and micturation center reported in animal studies.