脊髓排尿中枢局灶性缺血和逼尿肌外括约肌功能不协调.doc

Teaching NeuroImages :Focal ischemia of the spinal micturition center and detrusor-external sphincter dyssynergia
脊髓排尿中枢局灶性缺血和逼尿肌外括约肌功能协调失常
A 50-year-old woman presented with subarachnoid hemorrhage from a conus perimedullary fistula (figure 1A) involving the anterior spinal artery (ASA) She underwent liquid embolization, where reflu into the distal ASA occurred (figure 1B).
Postprocedure, she had difficulty initiating urination. Saddle and perianal sensation, rectal tone, and defecation were normal, as was the remainder of he neurologic examination.
Voiding cystourethrogram demonstrated detrusor external sphincter dyssynergia (figure 2A). Spinal MRI revealed conus T2 hyperintensity (figure 2B).
Sacral cord injury can result in detrusor-external sphincter case illustrates the location of the Onuf nucleus, the micturition center, which contracts the detrusor while relaxing the urethral sphincter. The patient’s symptoms resolved in 2 months.
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