Blackburn T, Dunn M
Division of Cardiovascular Diseases, University of Kansas Medical Center, Kansas City 66103.
Arch Intern Med. 1990 Dec;150(12):2577-8. doi: 10.1001/archinte.150.12.2577.
The diagnosis of acute mental status changes in the elderly patient is often very difficult. Many causes are possible, and there is often little history obtainable. The physical examination occasionally provides the essential clues needed to discover the source of the sudden deterioration. We have recently evaluated four episodes of acute delirium in three elderly patients who presented with no readily apparent cause for these changes. On further evaluation, the patients were found to have marked bladder distention associated with acute urinary retention. None of these patients complained of discomfort, and none had any awareness or recollection of their deterioration. Each patient had rapid resolution of symptoms on bladder decompression. To our knowledge, this "cystocerebral syndrome" has not been previously described, and we suggest that it be considered in the evaluation of acute confusional states in elderly men.
老年患者急性精神状态改变的诊断往往非常困难。可能的病因众多，且常常难以获取详细病史。体格检查偶尔能提供发现病情突然恶化根源所需的关键线索。我们最近评估了3例老年患者的4次急性谵妄发作，这些患者出现这些变化时并无明显病因。进一步检查发现，这些患者存在与急性尿潴留相关的明显膀胱膨胀。这些患者均未诉说不适，对自身病情恶化也毫无察觉或记忆。膀胱减压后，每位患者的症状均迅速缓解。据我们所知，此前尚未描述过这种“膀胱-脑综合征”，我们建议在评估老年男性急性意识模糊状态时考虑这一病症。
