What is Cystocerebral syndrome?
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.
Why does urinary retention cause confusion?
Increased bladder-wall tension induces increased sympathetic tonus and increased catecholamine production. These circulating catecholamines are thought to induce delirium.
Is a distended bladder serious?
When treated in the early stages, a distended bladder can be managed with relative ease and few long-term health complications. If left untreated for a long period of time, however, individuals may be susceptible to bladder damage, urinary tract infections, and kidney complications.
Can an enlarged prostate cause delirium?
We found that all patients reported in the literature were males older than 70 years and often with concomitant benign prostatic hypertrophy (BPH) who presented with acute episodes of delirium that rapidly responded to bladder decompression.
Why does UTI cause altered mental status?
These chemicals can also lead to many of the symptoms we feel, like fatigue or fevers. In older adults, the brain is more affected by the inflammation and the stress hormones that the body produces to fight the infection. The effects of this inflammation and stress on the brain are what show up as delirium.
Can urinary retention cause metabolic encephalopathy?
In the case of a UTI, it would be metabolic encephalopathy even in the absence of fever or other specific findings since many susceptible patients, especially the elderly, experience encephalopathy with any infection. Whenever “metabolic encephalopathy” is documented, code G93.
What causes urinary retention in elderly females?
Two of the most common causes of chronic urinary retention in women are bladder muscle dysfunction and obstruction.
What are the symptoms of urinary retention?
Chronic urinary retention
- the inability to completely empty your bladder when urinating.
- frequent urination in small amounts.
- difficulty starting the flow of urine, called hesitancy.
- a slow urine stream.
- the urgent need to urinate, but with little success.
- feeling the need to urinate after finishing urination.
Why do elderly retain urine?
The most common processes in the elderly are: Diabetic neuropathy: Urinary retention may appear in diabetic neuropathy, almost always related to an autonomic nervous system lesion.
What medications can cause metabolic encephalopathy?
Toxic encephalopathy
| Type of therapeutic agent | Drugs |
|---|---|
| Miscellaneous | Benzodiazepines |
| Antiepileptic agents (± seizures ; valproic acid – leukotoxic damage) | |
| Narcotics (± seizures) | |
| Anesthetic agents |
Can dehydration cause metabolic encephalopathy?
A: Metabolic encephalopathy is caused by such things as fever, dehydration, electrolyte imbalance, hypoglycemia, hypoxemia, any infection, and organ failure.
What is cystocerebral syndrome?
Review What is cystocerebral syndrome? Cystocerebral syndrome is broadly defined as encephalopathy or delirious state with features of agitation, paranoia, confusion, decreased responsiveness, and difficulty with redirection in the setting of bladder distention [2,3].
What happens if cystocerebral syndrome is left untreated?
Left untreated, cystocerebral syndrome may result in acute renal failure. It can develop rapidly (hours to days) and present as hypoactive (lethargy), hyperactive (restlessness), or mixed (combination of symptoms) delirium. Cystocerebral syndrome is a reversible condition that requires immediate attention.
How is cystocerebral syndrome (cystosarcoma) treated?
Cystocerebral syndrome is a reversible condition that requires immediate attention. Comorbidities should be assessed, especially if a patient complains of bowel or bladder discomfort. If the issue is urinary retention, immediate bladder decompression is needed. A coudé catheter is frequently used because it can better bypass BPH obstructions.
What should be included in the evaluation for cystocerebral syndrome?
Male individuals for whom there is a concern for cystocerebral syndrome should be evaluated for prior history of urinary retention, new medications, BPH, diabetes mellitus, constipation, and/or concerns for decreasing micturition. The timing of their altered mentation should be considered to ensure no other stressors are at play.
