Cystocerebral syndrome: A case report

Authors

  • Juan Manuel Escobar-Montalvo Sección de Neurofisiología Clínica, Servicio de Neurología, Hospital Universitario La Paz. Madrid, España. Centro de Referencia de Trastornos Complejos del Sistema Nervioso Autónomo, Servicio de Neurología, Hospital Universitario La Paz. Madrid, España.
  • Erika Herráez-Sanchez Sección de Neurofisiología Clínica, Servicio de Neurología, Hospital Universitario La Paz. Madrid, España
  • Javier Oliva Navarro Sección de Neurofisiología Clínica, Servicio de Neurología, Hospital Universitario La Paz. Madrid, España.
  • Rosario Torres Servicio de Urgencias, Hospital Universitario La Paz. Madrid, España.
  • Cristian Rízea Sección de Neurofisiología Clínica, Servicio de Neurología, Hospital Universitario La Paz. Madrid, España. Centro de Referencia de Trastornos Complejos del Sistema Nervioso Autónomo, Servicio de Neurología, Hospital Universitario La Paz. Madrid, España.

DOI:

https://doi.org/10.20453/rnp.v84i2.3999

Keywords:

Myoclonus, aged, delirium, urinary retention

Abstract

Cystocerebral syndrome was first described in 1990 by Blackburn and Dunn, in elderly males with acute confusion syndrome and urinary retention, who after bladder drainage experienced full resolution of the clinical picture. We report the case of an elderly male patient with Cystocerebral syndrome and symptoms such as a rapid decrease in consciousness level, myoclonies, hypotension, bradycardia and acute urinary retention who, after bladder drainage presented a complete remission of the clinical picture. The potential mechanisms involved in the origin of this syndrome are described, as well as its underlying hemodynamic and autonomic alterations. Cystocerebral syndrome should be considered in the differential diagnosis of patients with  a confusional syndrome and cognitive impairment, diagnosed with prostatic hypertrophy and presenting, in addition, an episode of acute urinary retention.

Downloads

Download data is not yet available.

References

Blackburn T, Dunn M. Cystocerebral syndrome. Acute urinary retention presenting as confusion in elderly patients. Arch Intern Med. 1990;150(12):2577- 8. doi: 10.1001/archinte.150.12.2577

Blè A, Zuliani G, Quarenghi C, Gallerani M, Fellin R. Cystocerebral syndrome: a case report and literature review. Aging (Milano). 2001;13(4):339- 42.

Waardenburg IE. Delirium caused by urinary retention in elderly people: a case report and literature review on the “cystocerebral syndrome”. J Am Geriatr Soc. 2008;56(12):2371-2.

Saga K, Kuriyama A, Kawata T, Kimura K. Neurogenic bladder presenting with cystocerebral syndrome. Intern Med. 2013;52(12):1443-4.

Shirvani N, Jimenez XF. Cystocerebral Syndrome: A Case Report and Review of Literature and Mechanisms. J Am Geriatr Soc. 2015; 63(12): 2645- 2647.

Liem PH, Carter WJ. Cystocerebral syndrome: a possible explanation. Arch Intern Med. 1991;151(9):1884-1886.

Thelmo F, Tzarnas S, Rosal N, Kramer M, Walters L. Cystocerebral Syndrome: An Updated Review and a New Proposed Mechanism for an Often Forgotten Cause of Delirium. Cureus. 2020.19;12(10):e11034.

Lee TM, Su SF, Chen MF, Tsai CH. Acute effects of urinary bladder distension on the coronary circulation in patients with early atherosclerosis. J Am Coll Cardiol. 2000;36(2):453-60. doi: 10.1016/s0735- 1097(00)00751-8

Tsung-Minglee L, Sheng-Fang S, Chang-Her Tsai. Effects of distension of urinary bladder on coronary conduit and resistance vessels in hyperlipidemic patients. Clin. Cardiol. 2002;25:467–473.

Vincent J. Understanding cardiac output. Critical Care. 2008;12:174. doi: 10.1186/cc6975

Ferrara N, Komici K, Corbi G, Pagano G, Furgi G, Rengo C, et al. β-adrenergic receptor responsiveness in aging heart and clinical implications. Front Physiol. 2014;4: 396. doi: 10.3389/fphys.2013.00396

Marcantonio E. Delirium in Hospitalized Older Adults. N Engl J Med. 2017;377(15):1456-1466. doi: 10.1056/NEJMcp1605501.

Published

2021-08-09

How to Cite

1.
Escobar-Montalvo JM, Herráez-Sanchez E, Oliva Navarro J, Torres R, Rízea C. Cystocerebral syndrome: A case report. Rev Neuropsiquiatr [Internet]. 2021 Aug. 9 [cited 2025 Dec. 27];84(2):128-31. Available from: https://revistas.upch.edu.pe/index.php/RNP/article/view/3999

Issue

Section

CASE REPORT