Abstract:
INTRODUCTION:An unusual case of urinary retention is reported occurring during the inpatient rehabilitation of minimally responsive state (MRS) following severe traumatic brain injury (TBI). CLINICAL PICTURE:Urodynamic evaluation showed detrusor acontractility and subsequent management involved intermittent bladder catheterization and treatment of a single urinary tract infection. TREATMENT:Factors contributing to her bladder paralysis included severe immobility, tetraplegia and treatment of diffuse spasticity with oral Dantrolene sodium 250 mg per day. Constipation, diabetes and spinal cord injury were absent. In addition, she received unilateral partial sciatic neurolysis with 50% alcohol for severe knee flexor spasticity and intra-muscular Botulinum toxin A to both spastic upper limbs. OUTCOME:Bladder acontractility resolved completely when Dantrolene was reduced with subsequent achievement of a catheter-free status and small post-void residual volumes. Repeat urodynamics showed spontaneous detrusor contractions. CONCLUSION:A discussion of possible aetiologic factors for detrusor acontracility following TBI is presented including a brief review of the literature.
journal_name
Brain Injjournal_title
Brain injuryauthors
Chua KS,Kong KHdoi
10.1080/02699050500110181subject
Has Abstractpub_date
2005-11-01 00:00:00pages
1063-6issue
12eissn
0269-9052issn
1362-301Xpii
H111P86685626586journal_volume
19pub_type
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