脳血管障害による神経因性膀胱に関する臨床的観察

Abstract

A cystometric study was made on 26 patients with sustained cerebral strokes whose cerebral lesions were confirmed by computerized tomography (CT scan). All of them had been free of organic obstruction of the lower urinary tract. These patients were divided into the cerebral infarction (16 cases), the subarachnoid bleeding (4 cases) and cerebral hemorrhage (6 cases) clinically. Moreover, cases of the cerebral infarction were subdivided into the cortical infarction (7 cases), the sub-cortical infarction (6 cases) and the cerebral atrophy (3 cases) from the findings of CT scan. The results are as follows. 1) Seven cases diagnosed as the cortical infarction showed the uninhibited type in 6 cases and the normal type in one case cystometrically. 2) Six cases diagnosed as the sub-cortical infarction showed the uninhibited type in 4 cases and the hypotonic type in 2 cases. 3) Cases of the subarachnoid bleeding and the cerebra hemorrhage showed both types. From these results, the following speculations became possible. a) The cortical infarction has a tendency to bring about the uninhibited neurogenic bladder. b) The sub-cortical infarction has a tendency to bring about the two types, the uninhibited and hypotonic neurogenic bladder. c) The subarachnoid bleeding and cerebral hemorrhage has a tendency to bring about the two types as well. d) Most cases complaining of dysuria are apt to accompany the psychological disorders, especially dementia. This kind of research should be continued in the future.