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A case of acute urinary retention caused by periaqueductal grey lesion
  1. H Yaguchi1,
  2. H Soma1,
  3. Y Miyazaki1,
  4. J Tashiro1,
  5. I Yabe1,
  6. S Kikuchi1,
  7. H Sasaki1,
  8. H Kakizaki2,
  9. F Moriwaka3,
  10. K Tashiro3
  1. 1Department of Neurology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
  2. 2Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
  3. 3School of Psychological Science, Health Sciences University of Hokkaido, Sapporo, Japan
  1. Correspondence to:
 Dr I Yabe
 Department of Neurology, Hokkaido University School of Medicine, N-15 W-7, Kita-ku, Sapporo 060-8638, Japan; yabemed.hokudai.ac.jp

https://doi.org/10.1136/jnnp.2003.027516

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    Diseases of the central nervous system often cause disturbances in micturition. These diseases include lesions in the spinal cord, pons, cerebellum, hypothalamus, basal ganglia, and cerebrum. Of these regions, the dorsomedial pontine tegmentum (pontine micturition centre, PMC), frontal lobe, and sacral spinal cord are considered important in controlling micturition. Recent studies in healthy humans using positron emission tomography (PET) have shown a significant increase in blood flow in the PMC and midbrain periaqueductal grey (PAG) during micturition and urine storage.1–3 Thus, in addition to the PMC, the PAG may play an important role in micturition control. However, to our knowledge, there is no clinical report that identifies the role of the PAG in micturition. Here we report a case of acute urinary retention caused by a small lesion in the PAG. A favourable response to steroid therapy resulted in the normalisation of micturition.

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