iothalamate-meglumine and Cerebrovascular-Disorders

The effect of radiographic contrast agents on the central nervous system was evaluated by measurement of serum creatine kinase B-subunit (CKB) levels with use of radioimmunoassay in 58 patients who underwent computed tomographic (CT) scanning and 46 patients who underwent cerebral angiography for evaluation of cerebrovascular diseases, brain tumors, and other neurologic disorders. In 11 patients (10.6%), the CKB increased to abnormally high levels within 4 hours after the radiographic procedures, and the median value after 30 minutes was significantly higher than the corresponding precontrast value (P less than 0.01). Eight of the 11 patients had recent ischemic cerebrovascular diseases, and 7 of the 11 had undergone CT scanning. On the basis of the information available in the literature, elevation of the serum CKB levels may be interpreted as reflecting breakdown of the blood-brain barrier and neural damage. Intravascularly administered radiographic media are generally safe, but the results of the current investigation suggested the potential for detrimental effects, particularly in patients with recent cerebrovascular diseases.

Topics: Brain; Brain Neoplasms; Cerebral Angiography; Cerebrovascular Disorders; Contrast Media; Creatine Kinase; Diatrizoate Meglumine; Humans; Iothalamate Meglumine; Isoenzymes; Tomography, X-Ray Computed

Rapid Sequence Tomography is shown to be a valid instrument to study the local distribution of more or less vascularized brain structures. Functional states as hypo- or hyperperfusion become clearly visible. RSCT permits a clear differentiation between intra- and extravascular contrast enhancement and offers an excellent insight into the angioarchitecture and quality of cerebral lesions.

Topics: Brain Neoplasms; Cerebrovascular Circulation; Cerebrovascular Disorders; Humans; Intracranial Arteriovenous Malformations; Iothalamate Meglumine; Tomography, X-Ray Computed

We have carried out basic investigations of an intravenous minimum dose bolus (MinDB) injection method for cerebral computed angiotomography by comparing blood iodine concentrations with high resolution computed tomography (CT) images of cerebral blood vessels. With the GECT/T 8800 scanner, a MinDB injection of 1 ml/kg of 60% Conray at a rate of 2 ml/s made it possible to increase the blood iodine concentration in the carotid artery to more than 15 mg/ml for about 20 s. Computed tomography performed during this period enabled us to obtain clear images of the circle of Willis, including other main cerebral arteries, deep veins, and cortical and lenticulostriate arteries. Cerebral computed angiotomography using this method should be useful for noninvasive screening or detection of cerebrovascular lesions themselves, such as cerebral aneurysms, cerebrovascular obstructions, arteriovenous malformations, and moyamoya disease, and should also be useful for determining the anatomical relationship between the cerebral blood vessels and other parenchymal or space occupying lesions.

Topics: Carotid Arteries; Cerebral Angiography; Cerebrovascular Disorders; Circle of Willis; Humans; Infusions, Parenteral; Injections, Intravenous; Iodine; Iothalamate Meglumine; Tomography, X-Ray Computed; Veins

An important computerized tomographic (CT) pattern is described, in which selective enhancement of cerebral gray matter occurs after intravenous administration of contrast medium. Analysis of 76 cases displaying the enhancement pattern revealed that the phenomenon occurs in diseases characterized by hypoxia, and may be attributed to regional vascular dysautoregulation. Eighty percent of these patients had primary cerebrovascular disease (infarctions or transient ischemic attacks); 20% with other disorders also had evidence of cerebral ischemia or infarction. When hypoxia progressed to infarction, the enhancement was accompanied by one or more parenchymal areas of decreased density. However, in transient ischemic attacks, it occurred without other parenchymal abnormality and represents the first recognized CT sign of cerebral hypoxia. Enhancement was observed within 3 weeks of onset in 80% of cases, but in 20% it persisted for up to 4 months, indicating a protracted state of dysautoregulation.

Topics: Adolescent; Aged; Brain; Cerebral Infarction; Cerebrovascular Disorders; Female; Humans; Hypoxia, Brain; Intracranial Aneurysm; Intracranial Arteriovenous Malformations; Iothalamate Meglumine; Ischemic Attack, Transient; Male; Middle Aged; Tomography, X-Ray Computed

The passage of contrast medium was observed using serial computed tomography (CT) in 24 stroke patients. Density--time profiles of various brain regions were plotted. In normal brain tissue, X-ray attenuation showed a maximum increase during the arterial phase (16.4 +/- 11.0%) and was 2.8 +/- 2.2% above control during stable distribution. In hypoperfusion, increase in attenuation was always below 10% in the arterial phase, while hyperperfusion was characterized by an attenuation increase of 25 to 70%. Enhancement was defined by a density increase of 16.8 +/- 14.8% and a tissue/blood ratio between 7 and 60%. An attempt was made to establish a relationship between the serial CT pattern and the prognosis. Enhancement tended to indicate severe morphological changes followed by permanent neurological deficit, whereas hyperperfusion was generally an indicator of probably recovery.

Topics: Adult; Aged; Blood-Brain Barrier; Brain; Cerebrovascular Disorders; Humans; Iothalamate Meglumine; Ischemic Attack, Transient; Middle Aged; Perfusion; Radiographic Image Enhancement; Tomography, X-Ray Computed

Topics: Angiography; Cerebral Angiography; Cerebrovascular Disorders; Contrast Media; Humans; Iothalamate Meglumine; Iothalamic Acid