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Published on: August 28, 2020
Urinary urgency after traumatic brain injury
Gabrielle Costain1, Jordanne Nichols Kirschke2, Cassie Cortes2
1Medical School, Rocky Vista University College of Osteopathic Medicine, Parker, Colorado, USA gabrielle.costain@ut.rvu.edu.
Insights
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.
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.
Abstract:
Traumatic brain injury (TBI) in paediatric patients can lead to various neurological and functional impairments, including urinary urgency and incontinence. This case study describes a young child who sustained a TBI after a fall from a second-storey window, resulting in a depressed skull fracture in the left frontal region and associated subarachnoid haemorrhage. Surgical intervention was required to stabilise the skull fracture and mitigate haemorrhage. Despite normal cognitive and speech abilities post-injury, the patient developed urinary urgency and incontinence during the recovery phase, which persisted intermittently over 2 years. Management of the incontinence involved intensive behavioural strategies, such as reinstating toilet training and addressing urinary tract infections, with symptoms largely resolving over the 2-year follow-up period. This case underscores the relationship between frontal TBI and bladder dysfunction in paediatric patients and emphasises the need for additional incontinence training and monitoring in young children following frontal TBI events.
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