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Case Reports in Nephrology
Volume 2017 (2017), Article ID 2582509, 3 pages
https://doi.org/10.1155/2017/2582509
Case Report

The Cushing Reflex: Oliguria as a Reflection of an Elevated Intracranial Pressure

1Department of Internal Medicine, University of Antwerp, Antwerp, Belgium
2Faculty of Medicine, University of Antwerp, Antwerp, Belgium
3Department of Neurosurgery, Antwerp University Hospital, Edegem, Antwerp, Belgium
4Department of Nephrology, Antwerp University Hospital, Edegem, Antwerp, Belgium
5Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, Edegem, Antwerp, Belgium

Correspondence should be addressed to K. Leyssens; moc.liamg@neirtaksnessyel

Received 8 March 2017; Accepted 11 April 2017; Published 15 May 2017

Academic Editor: Yoshihide Fujigaki

Copyright © 2017 K. Leyssens et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Oliguria is one of the clinical hallmarks of renal failure. The broad differential diagnosis is well known, but a rare cause of oliguria is intracranial hypertension (ICH). The actual knowledge to explain this relationship is scarce. Almost all literature is about animals where authors describe the Cushing reflex in response to ICH. We hypothesize that the Cushing reflex is translated towards the sympathetic nervous system and renin-angiotensin-aldosterone system with a subsequent reduction in medullary blood flow and oliguria. Recently, we were confronted with a patient who had complicated pituitary surgery and displayed multiple times an oliguria while he developed ICH.