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September 1991

Cystocerebral Syndrome: A Possible Explanation

Author Affiliations

Little Rock, Ark

Arch Intern Med. 1991;151(9):1884-1886. doi:10.1001/archinte.1991.00400090150034

To the Editor. —  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. A possible explanation for cystocerebral syndrome can be proposed based on our current knowledge of the neurophysiology of urinary bladder function and the involvement of neurotransmitters in delirium.While micturition is exerted through the parasympathetic nervous system, the ability of the detrusor muscle to relax during filling is controlled by the sympathetic nervous system via β receptors located throughout the bladder wall.2 When micturition cannot occur at the usual threshold (300 to 500 mL) for many reasons, a highly stressful situation occurs that increases adrenergic tension in both the peripheral and central nervous systems. Because the peripheral β-receptor responses are often blunted in senescence,3 excess catecholamine levels

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