iothalamate-meglumine and Spinal-Cord-Diseases

The author reports that side effects were somewhat more frequent after metrizamide than after meglumin-iocarmate, in the course of a comparative study carried out at the reporting hospital from the beginning of 1977, using the water-soluble x-ray contrast media Amipaque (metrizamide) and Dimer X (meglumin-iocarmate).

Topics: Clinical Trials as Topic; Female; Humans; Iothalamate Meglumine; Male; Metrizamide; Myelography; Spinal Cord Diseases

Metrizamide and meglumine iocarmate (Dimer-X), which at present are the contrast media for myelography best tolerated by central nervous system, were compared in a double-blind test comprising a total of 86 patients, all with symptoms of lumbar or sacral root involvement. Symptoms appearing were recorded using a standard interview formula 24 hoaurs after myelography. EEG, routine laboratory analyses of CSF and neurologic examinations were also made. In some cases CSF paper electrophoresis, CSF pressure recordings and determination of CSF iodine content were obtained.

Topics: Adult; Aerophagy; Aged; Blood Cell Count; Clinical Trials as Topic; Contrast Media; Female; Headache; Humans; Iodobenzoates; Iothalamate Meglumine; Iothalamic Acid; Male; Metrizamide; Middle Aged; Myelography; Pain; Spinal Cord Diseases

There are few reports of hemorrhagic central nervous system complications after chymopapain injection in humans. Two patients are reported who developed hemorrhagic complications after the lumbar injection of chymopapain. The first developed a hemorrhagic encephalomyelopathy followed by clinically suspected acute arachnoiditis, which responded to high doses of dexamethasone. The second patient developed subarachnoid hemorrhage secondary to vertebral artery aneurysm rupture after the injection of chymopapain.

Topics: Adult; Arachnoiditis; Cerebral Hemorrhage; Chymopapain; Diatrizoate Meglumine; Drug Interactions; Endopeptidases; Hemorrhage; Humans; Intervertebral Disc Displacement; Iothalamate Meglumine; Male; Metrizamide; Spinal Cord Diseases; Subarachnoid Hemorrhage

A critical literature review is presented on the basis of our own clinical experiences with complications and distressing side effects of the lumbar Dimer-X myelography. Severe Complications such as spinal and conuscauda-symptoms, epileptic seizures, amnestic episodes and late palsies of the Abducens nerve in literature range between 1 and 9%. Unspecific side effects which cannot clearly be differentiated from pure post-lumbal puncture complaints are reported to occur in up to 28%. The probably underlying pathogenetic mechanisms are discussed together with former animal experiments which revealed a local toxity of the contrast medium at the central nervous tissue and the surrounding membranes.

Topics: Abducens Nerve; Anaphylaxis; Epilepsy; Humans; Iothalamate Meglumine; Lumbosacral Region; Myelography; Paralysis; Spinal Cord Diseases

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

Topics: Humans; Iothalamate Meglumine; Myelography; Spinal Cord Diseases; Valsalva Maneuver