title: Micturitional disturbance in a patient with a spinal cavernous angioma.
abstract: A 58-year-old woman had a 3-year history of numbness in the right leg, which developed into thoracic transverse myelopathy and urinary retention. After referral to our department, MRI scans revealed a lesion with a target appearance at the T10-11 spinal cord with multiple silent cerebral lesions, which confirmed the diagnosis of cavernous angioma. Gamma-knife surgery was not indicated, considering the risk of adverse effects. The patient gradually became able to urinate, but had urge urinary incontinence. The first urodynamic studies (conducted 3 months after full clinical manifestations of transverse myelopathy) showed detrusor hyperreflexia (DH), decreased bladder sensation during bladder filling, detrusor-sphincter dyssynergia (DSD), and weak detrusor on voiding. However, urinary retention appeared again without change of neurologic signs. The second urodynamic studies (conducted 2 months later) showed less marked DH during bladder filling, and equivocal DSD but marked weak detrusor on voiding. The patient started taking oral prazosin hydrochloride (6 mg/day), which gradually ameliorated her voiding difficulty. Lesions in the lateral and dorsal columns of the spinal cord seem to be responsible for the micturitional disturbance in our patient with spinal cavernous angioma.
authors.affiliation: Neurology Department, Chiba University, Chiba, Japan. sakaki@med.m.chiba-u.ac.jp
authors.forename: Ryuji
authors.initials: R
authors.lastname: Sakakibara
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Uchiyama
authors.forename: Mitsuharu
authors.initials: M
authors.lastname: Yoshiyama
authors.forename: Akiyo
authors.initials: A
authors.lastname: Aotsuka
authors.forename: Masahiro
authors.initials: M
authors.lastname: Mori
authors.forename: Toshihide
authors.initials: T
authors.lastname: Kanesaka
authors.forename: Takamichi
authors.initials: T
authors.lastname: Hattori
authors.forename: Tomonori
authors.initials: T
authors.lastname: Yamanishi
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D004576:Electromyography; D005260:Female; D006392:Hemangioma, Cavernous / Q000150:complications* / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011224:Prazosin / Q000627:therapeutic use; D012021:Reflex, Abnormal / Q000502:physiology; D013125:Spinal Neoplasms / Q000150:complications* / Q000473:pathology; D001743:Urinary Bladder / Q000503:physiopathology; D014555:Urination Disorders / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D014563:Urodynamics
chemical_list: D000317:Adrenergic alpha-Antagonists; D011224:Prazosin