Department of Neurosurgery, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan.
Cerebellum. 2013 Oct;12(5):601-6. doi: 10.1007/s12311-013-0468-9.
Voiding dysfunctions are common neurological complications after a stroke, yet there are few urodynamic studies of patients with cerebellar stroke. We report the video urodynamic findings of 15 patients with cerebellar stroke, including eight patients with ischemic and seven with hemorrhagic stroke. Their mean age was 75 ± 13.4 years and the mean interval from stroke to video urodynamic study was 11.2 ± 17.9 months. At urodynamic study, four (50 %) patients with ischemic stroke had urinary incontinence as did two (28 %) patients with hemorrhagic stroke. Detrusor overactivity (DO) was found in eight (53 %) patients, dyssynergic urethral sphincter in six (40 %), and nonrelaxing urethral sphincter in seven (47 %). DO occurred in six (75 %) of patients with ischemic stroke and in two (28.6 %) of patients with hemorrhagic stroke (p = 0.072). While DO was not found in five of the 15 patients within 2 months after the stroke, it was more frequently detected in eight (80 %) of the 10 remaining patients 2 or more months after stroke (p = 0.007). Four (80 %) of the five stroke patients had nonrelaxing sphincter and urinary retention within 2 months after stroke. Two or more months after their strokes, coordinated sphincter function was noted in two (20 %) patients and dyssynergic sphincter was found in six (60 %); two (20 %) remained with nonrelaxing sphincter. Thus, lower urinary tract dysfunction caused by cerebellar stroke may change with time. Knowledge of video urodynamic findings should help us better manage voiding dysfunction in patients with cerebellar stroke.
排尿功能障碍是中风后的常见神经系统并发症，但对小脑卒中患者的尿动力学研究较少。我们报告了 15 例小脑卒中患者的视频尿动力学检查结果，包括 8 例缺血性卒中患者和 7 例出血性卒中患者。他们的平均年龄为 75±13.4 岁，从卒中到视频尿动力学检查的平均间隔为 11.2±17.9 个月。在尿动力学检查中，4 例（50%）缺血性卒中患者出现尿失禁，2 例（28%）出血性卒中患者出现尿失禁。8 例（53%）患者存在逼尿肌过度活动（DO），6 例（40%）患者存在协同性尿道括约肌功能障碍，7 例（47%）患者存在非松弛性尿道括约肌。在 6 例（75%）缺血性卒中患者和 2 例（28.6%）出血性卒中患者中发现 DO（p=0.072）。在卒中后 2 个月内，15 例患者中无 5 例发现 DO，但在其余 10 例患者中，2 例或 2 例以上的患者中更频繁地检测到 8 例（80%）（p=0.007）。在卒中后 2 个月内，5 例卒中患者中有 4 例（80%）存在非松弛性括约肌和尿潴留。在卒中后 2 或 2 个月以上，2 例（20%）患者出现协调的括约肌功能，6 例（60%）患者出现协同性括约肌功能障碍，2 例（20%）患者仍存在非松弛性括约肌。因此，小脑卒中引起的下尿路功能障碍可能会随时间而变化。对视频尿动力学检查结果的了解应有助于我们更好地管理小脑卒中患者的排尿功能障碍。
