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Urinary urgency after traumatic brain injury.

Gabrielle Costain1, Jordanne Nichols Kirschke2, Cassie Cortes2

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Pediatric traumatic brain injury (TBI) can cause bladder issues. This case study shows a child with frontal TBI developed incontinence, managed with behavioral strategies and resolved over two years.

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Area of Science:

  • Neuroscience
  • Pediatric Neurology
  • Urology

Background:

  • Traumatic brain injury (TBI) in children can result in diverse neurological deficits.
  • Frontal lobe injuries are particularly associated with changes in cognitive and behavioral functions, including bladder control.
  • Urinary urgency and incontinence are potential, though less commonly reported, sequelae of paediatric TBI.

Purpose of the Study:

  • To present a case study of a paediatric patient with frontal TBI and subsequent bladder dysfunction.
  • To highlight the relationship between frontal lobe injury and the development of urinary urgency and incontinence in children.
  • To discuss the management and outcomes of incontinence following paediatric TBI.

Main Methods:

  • A case report detailing a young child with a severe TBI from a fall.
  • Description of the injury (depressed skull fracture, subarachnoid hemorrhage) and surgical management.
  • Longitudinal observation of neurological recovery, cognitive function, and bladder control over a 2-year period.
  • Documentation of interventions for urinary incontinence, including behavioral strategies and management of urinary tract infections.

Main Results:

  • The patient, despite intact cognitive and speech functions, developed persistent urinary urgency and incontinence post-TBI.
  • Symptoms of incontinence were intermittent and lasted for over 2 years.
  • Intensive behavioral interventions, including toilet training and UTI management, led to significant symptom resolution.
  • The patient demonstrated substantial improvement in bladder control by the 2-year follow-up.

Conclusions:

  • Frontal TBI in paediatric patients can be linked to bladder dysfunction, specifically urinary urgency and incontinence.
  • Early and consistent behavioral interventions are crucial for managing incontinence in children post-TBI.
  • Ongoing monitoring and tailored management strategies are recommended for paediatric patients experiencing bladder issues after frontal TBI.