iothalamate-meglumine and Central-Nervous-System-Diseases

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

To determine the value of performing contrast CT in addition to non-contrast CT in the evaluation of acute non-traumatic central nervous system disorders, we retrospectively reviewed 322 cases originating from the emergency room at our institution. The most common indication for scanning was seizure activity (34% of total), followed by headache (30%), focal neurological deficit (10%), and altered mental status (8%). 75% of the non-contrast scans were normal. The contrast-enhanced scan revealed abnormalities not evident on the non-contrast scan in only three of these cases, and the information did not alter patient management. We conclude that in the acute setting, if a non-contrast CT is normal, a contrast study is usually unnecessary. Therefore, given the additional risks of contrast infusion, the contrast study, if needed, is generally best obtained at a later date, after more careful evaluation of the patient's history and medical records. If the non-contrast CT scan is abnormal, a contrast enhanced CT scan may be beneficial, but, again, is often not needed to direct acute patient management.

Topics: Acute Disease; Adolescent; Adult; Aged; Aged, 80 and over; Central Nervous System Diseases; Child; Contrast Media; Emergencies; Female; Humans; Iothalamate Meglumine; Male; Middle Aged; Predictive Value of Tests; Retrospective Studies; Tomography, X-Ray Computed

Topics: Central Nervous System Diseases; Humans; Iothalamate Meglumine; Myelography; Risk

Either arachnoriditis or dural/arachnoidal tears may cause symptoms in the postoperative spinal patient. Surgery and myelography as causes of arachnoiditis are discussed. Intradural arachnoid cyst formation and intramedullary cavitation may present as unusual sequelae of arachnoiditis. Extra-dural cysts and cerebrospinal fluid fistulas resulting from dural/arachnoidal tears are unusual postoperative complications presenting striking myelographic features. Their mechanisms of formation, clinical significance, and radiographic features are discussed.

Topics: Animals; Arachnoid; Arachnoiditis; Central Nervous System Diseases; Cerebrospinal Fluid; Contrast Media; Cysts; Dura Mater; Fistula; Iothalamate Meglumine; Mesylates; Metrizamide; Myelography; Postoperative Care; Postoperative Complications; Solubility; Spinal Cord Diseases; Steroids; Water

Central ventriculography was performed by catheterization of the third ventricle or puncture of the anterior horn of the lateral ventricle through the anterior fontanelle. Three different contrast media were compared in 138 cases. Densopax offered the following advantages over Conray and Triyosom 60 MG: Less discomfort to the patient, the procedure may be performed with the patient supine, no danger of embolization, and better demonstration of the aqueduct and fourth ventricle when the ventricular system is greatly dilated.

Topics: Adolescent; Central Nervous System Diseases; Cerebral Ventriculography; Child; Child, Preschool; Contrast Media; Diatrizoate; Diatrizoate Meglumine; Humans; Infant; Infant, Newborn; Iodobenzoates; Iothalamate Meglumine; Triiodobenzoic Acids