Urakawa M, Ueda Y
Department of Neurosurgery, Ogori Daiichi General Hospital, 862-3 Shimogo, Ogori, Yoshiki-gun, Yamaguchi 754-0002, Japan.
No To Shinkei. 2001 Aug;53(8):742-6.
A case of a 37-year-old man with urinary retention secondary to aseptic meningitis is described. He was admitted to our hospital with complaints of fever, nausea, headache, and gait disturbance. He had begun treatment 1 week previously for high fever, headache and joint pain at an outpatient department. On admission, neurological examination revealed neck stiffness, spasticity and hyperreflexia of the extremities, hypesthesia of the lower extremities, and ataxic gait. A spinal fluid examination revealed aseptic meningitis. Disturbed consciousness, diplopia, aphasia, tetraparesis, and urinary retention appeared after admission. Computed tomography and magnetic resonance imaging (MRI) of the head revealed no abnormal lesions. On the 2nd day of hospitalization, a Foley catheter was inserted for urinary retention. The patient was treated with conservative therapy, and his symptoms gradually resolved. The Foley catheter was removed on hospital day 13, but bladder dysfunction was persisted. MRI of the lumbar spine revealed herniated lumbar discs at level L3-4, L4-5, and L5-S1, but the nerve roots were not compressed. The patient was managed with clean intermittent catheterization for more than two weeks. Cystometry revealed atonic bladder. Nineteen cases of urinary retention secondary to aseptic meningitis have been reported in the previous literature. We reviewed their clinical presentation and treatment.
本文描述了一例37岁男性因无菌性脑膜炎继发尿潴留的病例。他因发热、恶心、头痛和步态障碍入院。他一周前开始在门诊治疗高热、头痛和关节疼痛。入院时，神经系统检查发现颈部僵硬、四肢痉挛和反射亢进、下肢感觉减退以及共济失调步态。脑脊液检查显示为无菌性脑膜炎。入院后出现意识障碍、复视、失语、四肢瘫和尿潴留。头部计算机断层扫描和磁共振成像（MRI）未发现异常病变。住院第2天，因尿潴留插入了Foley导尿管。患者接受了保守治疗，症状逐渐缓解。住院第13天拔除了Foley导尿管，但膀胱功能障碍持续存在。腰椎MRI显示L3 - 4、L4 - 5和L5 - S1水平腰椎间盘突出，但神经根未受压。患者接受了超过两周的清洁间歇性导尿治疗。膀胱测压显示膀胱无张力。先前文献中已报道19例无菌性脑膜炎继发尿潴留的病例。我们回顾了它们的临床表现和治疗方法。
