Cerebrovascular Accidents, Intracranial Tumors, and Voiding Dysfunction

Abstract

Cerebrovascular accidents (CVAs) and intracranial tumors are common pathologic processes that alter higher cortical function and normal urologic function. Voiding dysfunction is the most common urologic consequence of CVAs and intracranial tumors; however, patients may also have sexual problems related to these two disease processes. Voiding dysfunction is usually characterized by urinary incontinence, frequency, and urgency. There are two broad categories of CVAs: occlusive lesions and hemorrhagic lesions from trauma or vascular malformation. Brain tumors produce clinical symptoms by three mechanisms: infiltration along nerve fiber tracts, displacement of brain tissue with resulting increased intracranial pressure from vasogenic edema, and destruction of brain tissue by a rapidly growing tumor. Location of a tumor or CVA has a direct effect on the clinical presentation. It appears that patients with frontal cerebral lesions are more likely to have incontinence and other urinary storage symptoms than patients with lesions elsewhere in the cerebrum.