Urinary Dysfunction in Idiopathic Normal Pressure Hydrocephalus Ryuji Sakakibara 1,2 , Tomoyuki Uchiyama 2 , Takemasa Kanda 3 , Yoshitaka Uchida 4 , Masahiko Kishi 1 , Takamichi Hattori 2 1Neurology Division, Department of Internal Medicine, Sakura Medical Center, Toho University 2Department of Neurology, Graduate School of Medicine, Chiba University 3Department of Neurology, Tokyo Metropolitan Hospital 4Department of Radiology, Graduate School of Medicine, Chiba University Keyword: normal pressure hydrocephalus , urinary incontinence , detrusor overactivity , overactive bladder , frontal lobe pp.233-239
Published Date 2008/3/1
DOI https://doi.org/10.11477/mf.1416100237
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 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.

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