Acute Cerebrovascular Accident and Lower Urinary Tract Dysfunction: A Prospective Correlation of the Site of Brain Injury with Urodynamic Findings

Abstract

PURPOSE: We evaluated the effects of an acute cerebrovascular accident on the lower urinary tract and correlated the site of cerebrovascular accident with findings on urodynamic study. MATERIALS AND METHODS: A total of 45 men and 15 women underwent a complete urodynamic study with electromyography within 72 hours of a cerebrovascular accident. Patients were divided into 5 different groups based on urodynamic findings. RESULTS: The majority of cortical and internal capsule lesions resulted in detrusor hyperreflexia. A total of 28 patients (47%) had urinary retention, mainly due to detrusor areflexia (75%). Of 20 patients with hemorrhagic infarcts 17 (85%) had areflexia, compared to only 4 of 40 (10%) with ischemic infarcts. All 6 patients with cerebellar infarction had detrusor areflexia. CONCLUSIONS: Our results confirm many previously reported findings. In addition, there was a specific correlation of cerebellar and hemorrhagic infarctions with detrusor areflexia.