Conflict of Interest: The authors have reported no conflicts of interest.
Neurogenic Bladder Due to Hypoxic-Ischemic Demyelination
Article first published online: 22 OCT 2007
©2008 by the American Society of Neuroimaging
Journal of Neuroimaging
Volume 18, Issue 2, pages 198–201, April 2008
How to Cite
Ramchandren, S. and Liebeskind, D. S. (2008), Neurogenic Bladder Due to Hypoxic-Ischemic Demyelination. Journal of Neuroimaging, 18: 198–201. doi: 10.1111/j.1552-6569.2007.00167.x
- Issue published online: 22 OCT 2007
- Article first published online: 22 OCT 2007
- Acceptance: Received October 6, 2006, and in revised form May 24, 2007. Accepted for publication June 18, 2007.
- neurogenic bladder;
- Wallerian degeneration
BACKGROUND AND PURPOSE
Hypoxia is commonly known to target neuronal cell bodies. Although myelin is a non-infrequent target, posthypoxic demyelination is a rarely described entity. We describe the case of a man who developed neurogenic bladder following a motor vehicle accident.
Following a severe motor-vehicle accident involving massive blood loss, a 46-year-old man developed urinary urgency requiring catheterization, with hyperactive reflexes and bilateral Babinski signs on exam.
Magnetic resonance imaging of the brain and cervical cord revealed diffuse, isolated white matter signal abnormality in a symmetric, confluent distribution, extending inferiorly into the spinal cord, with changes consistent with bilateral Wallerian degeneration. Serologic and CSF evaluations were normal.
Unlike previous reports of hypoxic-ischemic demyelination, our patient lacked any cortical abnormalities, presumably due to isolated white matter changes. This report alerts physicians to the possibility of hypoxic-ischemic demyelination due to global hypoxia-ischemia as an etiologic factor for neurogenic bladder.