Poststroke detrusor hyporeflexia in a patient with left medial pontine infarction

Although prognostically and socially significant for both patients and their caregivers, poststroke urinary incontinence (PSUI) is often easily overlooked or is not well studied because of its clinical variety in humans.

A 45-year-old woman with poorly controlled hypertension presented with acute right-sided hemiparesis and dysarthria. Acute urinary retention was diagnosed 2 days after stroke onset, along with the clinical evolution (The National Institutes of Health Stroke Scale from 1 to 7; Medical Research Council scale from 4 to 2). Brain magnetic resonance imaging showed an acute left medial pontine infarction, whereas urodynamic study showed detrusor hyporeflexia 5 days after the stroke. PSUI started to improve along with urodynamic studies 10 days later and the Foley catheter was removed subsequently.

Left medial pontine infarct causes detrusor hyporeflexia, which has not, to our knowledge, been reported in the literature. More attention should be given to the appearance of PSUI because of its prognostic importance and because patients may not recognize their neurogenic bladder symptoms during the acute cerebral shock phase.