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Cystocerebral Syndrome: A Possible Explanation

Cystocerebral Syndrome: A Possible Explanation Abstract To the Editor. — Cystocerebral syndrome, a term proposed by Black-burn and Dunn to describe delirium resulting from acute urinary retention in elderly patients, is indeed a common problem encountered in our geriatric clinical practice, which reverses rapidly with bladder decompression. A possible explanation for cystocerebral syndrome can be proposed based on our current knowledge of the neurophysiology of urinary bladder function and the involvement of neurotransmitters in delirium.While micturition is exerted through the parasympathetic nervous system, the ability of the detrusor muscle to relax during filling is controlled by the sympathetic nervous system via β receptors located throughout the bladder wall.2 When micturition cannot occur at the usual threshold (300 to 500 mL) for many reasons, a highly stressful situation occurs that increases adrenergic tension in both the peripheral and central nervous systems. Because the peripheral β-receptor responses are often blunted in senescence,3 excess catecholamine levels References 1. Blackburn T, Dunn M. Cystocerebral syndrome: acute urinary retention presenting as confusion in elderly patients . Arch Intern Med. 1990;150:2577-2578.Crossref 2. Fuchs EF. Urological disorders . In: Cassel C, Walsh J, eds. Geriatric Medicine . New York, NY: Springer-Verlag NY Inc; 1984:268-279. 3. Scrapace PJ, Abrass IB. Beta-adrenergic—mediated desensitization in senescent rats . Mech Ageing Dev. 1986;35:255-264.Crossref 4. Achenheil M, Athen D, Beckmann H. Pathophysiology of delirious states . J Neural Transm Suppl. 1978;14:167-175. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Cystocerebral Syndrome: A Possible Explanation

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Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1991.00400090150034
Publisher site
See Article on Publisher Site

Abstract

Abstract To the Editor. — Cystocerebral syndrome, a term proposed by Black-burn and Dunn to describe delirium resulting from acute urinary retention in elderly patients, is indeed a common problem encountered in our geriatric clinical practice, which reverses rapidly with bladder decompression. A possible explanation for cystocerebral syndrome can be proposed based on our current knowledge of the neurophysiology of urinary bladder function and the involvement of neurotransmitters in delirium.While micturition is exerted through the parasympathetic nervous system, the ability of the detrusor muscle to relax during filling is controlled by the sympathetic nervous system via β receptors located throughout the bladder wall.2 When micturition cannot occur at the usual threshold (300 to 500 mL) for many reasons, a highly stressful situation occurs that increases adrenergic tension in both the peripheral and central nervous systems. Because the peripheral β-receptor responses are often blunted in senescence,3 excess catecholamine levels References 1. Blackburn T, Dunn M. Cystocerebral syndrome: acute urinary retention presenting as confusion in elderly patients . Arch Intern Med. 1990;150:2577-2578.Crossref 2. Fuchs EF. Urological disorders . In: Cassel C, Walsh J, eds. Geriatric Medicine . New York, NY: Springer-Verlag NY Inc; 1984:268-279. 3. Scrapace PJ, Abrass IB. Beta-adrenergic—mediated desensitization in senescent rats . Mech Ageing Dev. 1986;35:255-264.Crossref 4. Achenheil M, Athen D, Beckmann H. Pathophysiology of delirious states . J Neural Transm Suppl. 1978;14:167-175.

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Sep 1, 1991

References