iothalamate-meglumine and Subarachnoid-Hemorrhage

We report the first case of MRI-documented cervical spinal cord injury during cerebral angiography. A 54-year-old woman underwent an angiogram for subarachnoid hemorrhage. Her head was secured in a plastic head-holder. At the end of the procedure, she was found to have a left hemiparesis. MRI revealed high signal in the cervical spinal cord. The etiology may have been mechanical due to patient positioning, or toxic, from contrast medium injection in the vessels feeding the spinal cord, or a combination of both.

Topics: Cerebral Angiography; Contrast Media; Female; Humans; Iothalamate Meglumine; Ioxaglic Acid; Magnetic Resonance Imaging; Middle Aged; Neurologic Examination; Spinal Cord; Spinal Cord Compression; Spinal Cord Injuries; Subarachnoid Hemorrhage

Topics: Adult; Aged; Cerebral Angiography; Female; Humans; Intracranial Aneurysm; Iothalamate Meglumine; Male; Middle Aged; Subarachnoid Hemorrhage; Tomography, X-Ray Computed

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

To elucidate the relationship between abnormal enhancement of the cisterns on computed tomography and cerebral vasospasm, we performed a systematic and prospective study in 60 patients with ruptured cerebral aneurysms. There is a significant relationship between the findings of contrast-enhanced computed tomography (CECT) within Day 3 of rupture and cerebral vasospasm. Among 37 patients undergoing CECT between Day 0 and Day 3, 17 (46%) showed prominent increases in density in the region around the circle of Willis and its branches. In 13 of 17 cases (76%), severe vasospasm with motor paralysis occurred. In the remaining 4 cases (24%) with only slight or no cerebral vasospasm, the hematoma in the subarachnoid space was removed surgically by Day 3. In 19 of 20 cases without remarkable CECT, no severe cerebral vasospasm with motor paralysis occurred. There is no significant relationship between the CECT findings after Day 3 and cerebral vasospasm. The results indicate that the prominent increase in density in the region of the circle of Willis and its branches often observed on CECT within Day 3 of subarachnoid hemorrhage is useful for prediction of the occurrence of cerebral vasospasm and also provide information on the pathogenesis of cerebral vasospasm.

Topics: Aged; Circle of Willis; Female; Humans; Intracranial Aneurysm; Iothalamate Meglumine; Ischemic Attack, Transient; Male; Middle Aged; Prospective Studies; Radiographic Image Enhancement; Subarachnoid Hemorrhage; Tomography, X-Ray Computed

Topics: Aged; Female; Humans; Intracranial Aneurysm; Iothalamate Meglumine; Ischemic Attack, Transient; Male; Middle Aged; Prospective Studies; Radiographic Image Enhancement; Subarachnoid Hemorrhage; Tomography, X-Ray Computed

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