metrizamide and Central-Nervous-System-Diseases

The most important complications of intravascular administration of contrast agents include idiosyncratic (anaphylactoid) reactions, shock, congestive heart failure, cardiac arrhythmias, acute renal failure, and neurotoxic effects. The incidence of serious neurotoxic effects is low. Entry of contrast agents into the central nervous system normally is limited but may be increased by osmotic opening of the blood-brain barrier with cerebral arteriography or arch aortography. Most neurotoxic effects are thought to represent direct effects of the contrast agent on brain or spinal cord. Adverse effects with arteriography include seizures, transient cortical blindness, brain edema, and spinal cord injury. Most cases of focal brain deficit (other than cortical blindness) are attributed to embolism secondary to the catheter. Seizures may occur with intravenous administration, especially in patients with brain tumors or other processes disrupting the blood-brain barrier. The most important adverse effects observed with myelographic agents include acute and chronic meningeal reactions with iophendylate, and seizures and transient encephalopathy with metrizamide.

Topics: Animals; Blindness; Blood-Brain Barrier; Brain Diseases; Brain Edema; Central Nervous System Diseases; Cerebrovascular Disorders; Contrast Media; Diatrizoate; Dose-Response Relationship, Drug; Epilepsy; Humans; Injections, Intravenous; Injections, Spinal; Iophendylate; Metrizamide; Rabbits; Spinal Cord Diseases; Visual Cortex

Topics: Central Nervous System Diseases; Humans; Metrizamide

A prospective study of EEG changes following metrizamide myelography was made on 34 patients aged 17-79 years. EEGs were recorded just before and 22-26 hours after myelography. Usually 8-10 ml of metrizamide was injected by either lumbar or lateral cervical puncture. The concentration of metrizamide was relatively high. EEGs were abnormal in 15 out of the 20 patients whose baseline EEGs were normal. EEGs deteriorated in 10 of the 14 patients whose control tracings were abnormal. High voltage delta activity and/or a great deal of theta activity were common abnormalities. Three patients showed triphasic waves. No relationships were found between the EEG changes and clinical variables. But central nervous system involvements by metrizamide tended to be accompanied by a severe EEG slowing.

Topics: Adolescent; Adult; Aged; Brain Diseases; Central Nervous System Diseases; Electroencephalography; Female; Headache; Humans; Male; Metrizamide; Middle Aged; Myelography; Nausea; Prospective Studies; Vomiting

Topics: Adolescent; Adult; Aphasia; Central Nervous System Diseases; Electroencephalography; Epilepsies, Myoclonic; Female; Humans; Iopamidol; Iothalamic Acid; Male; Metrizamide; Middle Aged; Myelography; Seizures; Time Factors

Metrizamide (Amipaque) is a new water-soluble contrast agent for use in the intrathecal space. Extensive animal and clinical studies have demonstrated its low toxicity. The advantages to the use of metrizamide include the fact that it is miscible with cerebrospinal fluid and can fill narrow spaces, is sufficiently radiopaque to outline delicate structures within the central nervous system, is completely resorbed from the subarachnoid space, and, to date, has not been implicated in the formation of adhesive arachnoiditis. Application of metrizamide to the evaluation of neurologically diseased patients has included myelography, intracranial cisternography, and ventriculography, as well as various techniques in conjunction with computerized tomography. These various uses of metrizamide are discussed together with some indications and advantages. Metrizamide has now replaced Pantopaque and gas as the most commonly used intrathecal contrast agent at the University of Texas Health Science Center at Dallas.

Topics: Adult; Brain; Central Nervous System; Central Nervous System Diseases; Cerebral Ventriculography; Cerebrospinal Fluid Rhinorrhea; Child; Child, Preschool; Humans; Infant; Infant, Newborn; Metrizamide; Myelography; Pneumoencephalography; Tomography, X-Ray Computed

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