Incontinence after brain glioma surgery: new insights into the cortical control of micturition and continence. Case report.
Cortical control of micturition and continence remains poorly understood. The authors report two cases of patients who presented with prolonged urinary disturbances after resection of a brain glioma. Accurate anatomofunctional correlations determined using postoperative magnetic resonance imaging support the following: 1) the implication of the posterior portion of the right anterior cingulate gyms in the perception of bladder sensation and maintenance of continence; 2) the involvement of the right anterior insula in bladder relaxation; and 3) the role of the right inferior frontal cortex in the decision concerning whether to initiate a micturition. On the basis of these results, a preliminary model of a cortical network associated with micturition and continence is proposed.
Duffau
Hugues
H
Department of Neurosurgery, Hôpital Salpêtrière, Paris, France. hugues.duffau@psl.ap-hop-paris.fr
Capelle
Laurent
L
D000328:Adult; D001932:Brain Neoplasms / Q000473:pathology* / Q000601:surgery*; D002540:Cerebral Cortex / Q000098:blood supply / Q000503:physiopathology; D005260:Female; D005625:Frontal Lobe / Q000098:blood supply / Q000503:physiopathology; D005910:Glioma / Q000473:pathology* / Q000601:surgery*; D006179:Gyrus Cinguli / Q000098:blood supply / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D011183:Postoperative Complications; D001743:Urinary Bladder / Q000503:physiopathology; D014549:Urinary Incontinence / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology