iothalamate-meglumine and Brain-Injuries

Paraosteoarthropathy (POA) is a frequent disabling orthopedic complication after severe central neurological impairment. The hip is the most frequently affected joint (32.1%) followed by the elbow and the shoulder (25%).. To evaluate coraco- and costoclavicular paraosteoarthropathy in patients with severe central neurological disorders.. We report a series of five consecutive patients with severe central neurological disorders who developed a POA of the clavicular region (coracoclavicular or costoclavicular POA). Every patient underwent a clinical, radiological, and computed tomographic (CT) examination of the shoulder region.. Four patients had a history of traumatic brain injury (TBI), and one an acute disseminated encephalomyelitis (ADEM). They developed POA of the clavicular region, although not around the glenohumeral joint. The patients complained of shoulder pain and of moderate limitation of movements. Radiological and CT examinations showed the presence of a bony formation in the coracoclavicular space in four cases and extending from the clavicle to the first rib around the costoclavicular joint in one case.. In patients with severe brain lesions suffering from shoulder pain and moderate limitation of joint movements, POAs of the clavicular region are rare but should be considered.

Topics: Adult; Brain Injuries; Central Nervous System Diseases; Clavicle; Contrast Media; Diagnosis, Differential; Encephalomyelitis, Acute Disseminated; Female; Humans; Iothalamate Meglumine; Male; Middle Aged; Ossification, Heterotopic; Osteoarthritis; Radiographic Image Enhancement; Range of Motion, Articular; Severity of Illness Index; Shoulder Joint; Shoulder Pain; Tomography, Spiral Computed; Tomography, X-Ray Computed

Meglumine iothalamate, an iodinated contrast agent, is commonly used in humans for roentgenographic outlining of cerebral ventricles. Although clinical studies have shown meglumine iothalamate to be less toxic than other radiopaque materials, its microscopic effects on brain tissue have never been studied in a controlled manner. For this study canine cerebral tissue was exposed to intraventricular saline or saline plus meglumine iothalamate and the results were compared by light microscopy. Reactive changes were found in both groups. They occurred with greater frequency and degree in the group exposed to meglumine iothalamate, but permanent damage to brain tissue, did not occur.

Topics: Animals; Brain Injuries; Cerebral Ventriculography; Contrast Media; Dogs; Iothalamate Meglumine; Iothalamic Acid

There were incidences of 0.7% severe and 5.5% mild complications in 1,971 direct puncture carotid angiograms done over a 5-year period. In 1,035 retrograde branchial angiograms, there was a 0.6% incidence of severe, and a 4.7% incidence of mild, complications. Complications tended to increase with increasing age of the patient. Brachial angiography is virtually free of life-threatening complications, and the incidence of neurological sequelae was markedly less than that shown by a comparable analysis of catheter angiography. Of patients undergoing 1,542 fractional pneumoencephalograms, 2 had severe complications.

Topics: Adolescent; Adult; Aged; Brachial Artery; Brain Injuries; Bronchial Spasm; Carotid Arteries; Cerebral Angiography; Child; Child, Preschool; Contrast Media; Female; Humans; Hypersensitivity; Infant; Infant, Newborn; Injections, Intra-Arterial; Iothalamate Meglumine; Male; Middle Aged; Pneumoencephalography; Respiration Disorders; Thrombosis