[Urinary dysfunction in idiopathic normal pressure hydrocephalus].
Urinary incontinence (UI) is a significant burden in the elderly and their caregivers when assessed by quality-of-life measures, early institutionalization, or health economics. UI is well known as a clinical triad for the diagnosis of normal pressure hydrocephalus (NPH). However, other than UI, NPH patients commonly have urinary urgency/frequency (overactive bladder: OAB), and less commonly, voiding difficulty. Fourteen percent of the patients (either women or men) have post-void residual > 100 ml. The most common urodynamic abnormality is detrusor overactivity (DO), which was noted in 95% of patients. The underlying pathophysiology for OAB/DO in patients with NPH seems to be decreased cerebral blood flow in the right frontal cortex, and to a lesser extent, altered basal ganglia function. Functional UI can overlap the OAB/DO due secondary to impaired cognition/initiative, immobility, or disturbed consciousness in this disorder.
Sakakibara
Ryuji
R
Neurology Division, Department of Internal Medicine, Sakura Medical Center, Toho University, Shimoshizu, Sakura, Chiba 285 8741, Japan.
Uchiyama
Tomoyuki
T
Kanda
Takemasa
T
Uchida
Yoshitaka
Y
Kishi
Masahiko
M
Hattori
Takamichi
T
D001341:Autonomic Nervous System / Q000502:physiology; D002560:Cerebrovascular Circulation; D005260:Female; D005625:Frontal Lobe / Q000098:blood supply; D006801:Humans; D006850:Hydrocephalus, Normal Pressure; D008297:Male; D013577:Syndrome; D014554:Urination / Q000502:physiology; D014555:Urination Disorders / Q000209:etiology / Q000503:physiopathology