The cortical representation of micturition is speculated to reside in the medial frontal lobes.^1,2 Lesion pathology, however, varies from acute stroke to a neoplasm, and there is not necessarily a small, distinct lesion.² We report a case of urinary retention in which the main presenting symptom is thought to have been caused by a small cortical infarction.

Case report

One morning, a 66 year old, right handed man had difficulty urinating. He had no history of voiding difficulty, diabetes mellitus, injury to the lower urinary tract, or neurological disease. Digital rectal examination and ultrasonography of the prostate detected no enlargement. Urinalysis showed no haematuria or pyuria. He was not taking any medications that cause voiding dysfunction. There was no urinary incontinence, but he had difficulty in voiding even though he felt the bladder was full. At that time, he also had difficulty in lifting his left arm and leg and so was brought to our hospital. Neurological examination in the emergency room found no weakness, and he was sent home. Later, he experienced urinary retention and visited the emergency …