metrizamide and Subarachnoid-Hemorrhage

Topics: Adult; Biopsy; Brain Neoplasms; Cerebral Infarction; Child, Preschool; Cysts; Diagnosis, Differential; Diagnostic Errors; Hematoma; Humans; Intracranial Aneurysm; Male; Metrizamide; Middle Aged; Neuromuscular Diseases; Paranasal Sinus Neoplasms; Spinal Cord; Spine; Subarachnoid Hemorrhage; Tomography, X-Ray Computed

A subarachnoid haemorrhage (SAH) in the squirrel monkey was produced by injection of blood via a permanently implanted catheter connected to the cisterna magna and a cannula stereotactically inserted into the interpeduncular cistern. Repeated angiographic examinations of the vertebro-basilar and right internal carotid arteries revealed a biphasic vasospasm with a maximal acute spasm at ten minutes and maximal late spasm at six days after blood injection. The present study has shown that a reproducible biphasic vasospasm can be produced in the squirrel monkey and evaluated by repeated angiographic examinations. The model is suitable in the study of basic mechanisms underlying vasospasm in a primate and, due to the size of the animal, autoradiographic evaluation of the cerebral blood flow and metabolism can be performed at an acceptable cost.

Topics: Animals; Cerebral Angiography; Disease Models, Animal; Female; Intracranial Pressure; Ischemic Attack, Transient; Male; Metrizamide; Saimiri; Subarachnoid Hemorrhage; Vertebrobasilar Insufficiency

One case of subarachnoid haemorrhage due to a spinal cord tumor, seen in a child, is reported. This exceptional etiology, whose the look is often misleading must be called to mind when meningeal and rachidian syndromes are associated. Ependymoma of cauda equina is the most common tumor.

Topics: Adolescent; Child; Ependymoma; Humans; Lymphography; Male; Metrizamide; Spinal Cord Neoplasms; 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

The effect of iopamidol on the leptomeninges was tested and compared with that of metrizamide and normal saline solution in 18 dogs. Pathologic and clinical effects were evaluated at 24 hours and 14 days after cisternal injection of iopamidol, metrizamide, or normal saline solution. Pathologic changes were evaluated by microscopic examination of serial CSF samples and of sections of brain and spinal cord with the leptomeninges intact. Clinical changes were subjectively evaluated. Electromyograms and EEG were performed on each dog after physical and neurologic examination. There were no changes seen in neurologic status, electromyogram, or EEG in any of the dogs immediately after subarachnoid injection nor at 24 hours or 14 days later. Pathologic changes were limited to mild, moderate, or severe patchy hemorrhagic leptomeningitis seen at 24 hours after iopamidol or metrizamide was injected. The severity of changes were judged to be similar with both these agents. The CSF analysis and histologic evaluation of brain and spinal cord sections revealed a neutrophilic response to iopamidol and a mononuclear response to metrizamide. These findings indicate that iopamidol has minimal neurotoxicologic effect on the leptomeninges and therefore has merit as a myelographic agent.

Topics: Animals; Arachnoid; Contrast Media; Dog Diseases; Dogs; Female; Iopamidol; Iothalamic Acid; Male; Meningitis, Aseptic; Metrizamide; Pia Mater; Subarachnoid Hemorrhage

Metrizamide CT cisternograms were performed on 39 patients with a clinical diagnosis of CSF abnormalities; 20 of these patients underwent radionuclide cisternography as well. Comparison of metrizamide CT and RN cisternography revealed good correlation in the degree, extent, and time sequence of ventricular reflux as well as the extent of cortical staining and cisternal filling. Metrizamide cisternography had the advantage of excellent anatomic detail and lower exposure dose, although minor complications were more frequent with this technique. Metrizamide CT cisternography has a potential to become the preferred method of evaluating patients with abnormal CSF dynamics.

Topics: Adolescent; Adult; Aged; Brain; Brain Diseases; Cerebrospinal Fluid; Child; Female; Humans; Hydrocephalus, Normal Pressure; Male; Metrizamide; Middle Aged; Radionuclide Imaging; Subarachnoid Hemorrhage; Tomography, X-Ray Computed