Cuadro urodinámico en la isquemia medular alta, inducida por el uso adictivo de cocaína. Descripción de un caso.

The authors present a case of spinal cord ischemia at level C2 related to cocaine use. The neurologic pattern was an anterior cord hemisection syndrome. Urodynamic assessment was performed at 6 and 14 months from the neurovascular event. The ice-water test (IWT) showed an uninhibited bladder cooling reflex, despite an areflexic detrusor (at routine filling cystometry). Occult bladder hyperreflexia became overt during the following month and was registered by the second urodynamic assessment. Anatomical bases of spinal cord blood supply are discussed. The authors emphasize the role of the IWT in predicting the development of overt bladder hyperreflexia and thus, spinal shock phase resolution.