iothalamate-meglumine and Sciatica

Twenty-five patients clinically suspected of herniated lumbar disk have undergone a CT examination before and 40 min after contrast enhancement. In every case, 13 of which were surgically verified, significant contrast enhancement of herniated disks was seen; there was only one false positive case. The authors conclude that late contrast enhancement really improves the CT diagnosis of herniated lumbar disk, particularly in cases with a doubtful or negative precontrast scan. The mechanism of the late contrast enhancement is discussed.

Topics: Adult; Aged; Diagnosis, Differential; Female; Humans; Intervertebral Disc Displacement; Iothalamate Meglumine; Lumbar Vertebrae; Male; Middle Aged; Radiographic Image Enhancement; Sciatica; Tomography, X-Ray Computed

Lumbar radiculographs were obtained in 252 patients with suspected disk herniation. Fifteen patients who underwent previous radiculography with Dimer-X plus Depo-Medrol exhibited adhesive arachnoiditis. This was not observed in 6 patients who received Dimer-X alone. No positive correlation between radiological diagnosis of adhesive arachnoiditis and clinical symptoms can be demonstrated. The authors suggest that steroids not be used intrathecally in combination with water-soluble contrast media.

Topics: Adult; Arachnoiditis; Humans; Intervertebral Disc Displacement; Iothalamate Meglumine; Iothalamic Acid; Methylprednisolone; Middle Aged; Myelography; Sciatica

A case is presented of convulsions, subarachnoid haemorrhage and death following the use of meglumine iothalamate 280 for myelography. The patient was suffering from sciatica but had no pre-existing symptoms of other neurological disease. This case dramatically illustrates the dangers inherent in the use of meglumine iothalamate 280 for myelography.

Topics: Humans; Iothalamate Meglumine; Iothalamic Acid; Male; Middle Aged; Myelography; Sciatica; Seizures; Subarachnoid Hemorrhage