Spinal fracture following radiculography using meglumine iothalamate (Conray)

Fatal ascending tonic-clonic seizure syndrome

A fatal case of ascending tonic-clonic seizure (ATCS) syndrome resulted from the inadvertent, unrecognized use of a hyperosmolar ionic contrast agent during myelography. The patient presented with lower-extremity myoclonic jerking, agitation, hyperthermia, rhabdomyolysis, and disseminated intravascular coagulation. Emergency physicians must be cognizant of this unique toxidrome to initiate early, aggressive care.

Accidental intrathecal injection of ionic water-soluble contrast medium: report of a case, including treatment

We report a patient who inadvertently received a small amount of meglumine diatrizoate intrathecally. The physiopathology and treatment of this kind of accident are discussed.

Myelography with iohexol (Omnipaque); a clinical report with special reference to the adverse effects

One thousand myelographies (370 cervical, 77 thoracic and 553 lumbar examinations) with iohexol (Omnipaque) were performed in 922 patients. No convulsions were seen. Transient hallucinations were reported in one patient. Headache occurred in 38%. The highest frequency of headache (52%) was reported following cervical myelography with lumbar puncture technique, placing the patient horizontally after the examination. The lowest frequency (20%) occurred following cervical myelography with the C1-C2 puncture technique, placing the patient in bed with the head end elevated 20 degrees. Lumbar myelography was performed on an out-patient basis in 243 patients. The frequency of headache was slightly higher (49%) in this group than in the other lumbar myelography patients (34-44%), but no serious complications were seen.

Gross deformity of the spine; a lumbar myelographic risk with Conray and Dimer X

Convulsions and fracture of the neck of the femur following myelography with Conray and Dimer X are reported in two patients with a gross post-tuberculous gibbus deformity of the thoracic spine. The possible causes of the increased risk associated with myelography of the patients with gibbus are discussed.

A clinical trial of Amipaque in lumbar myelography

Three hundred lumbar myelographies using a new water-soluble, non-electrolytic contrast medium, Amipaque, were assessed with reference to: 1) the correlation between radiological and operative diagnosis; 2) the side-effects during and after the myelography. Myelograms of the same reliability as those obtained with other water-soluble contrast media were obtained. However, arachnoiditis as sequelae to previous myelography with oil-soluble and earlier water-soluble contrast media prevented the correct evaluation in some cases. Spinal anaesthesia was not necessary. There was no case of muscle spasms or other serious complication. Eight patients who were re-examined with Amipaque more than two months later revealed no evidence of arachnoiditis as sequelae to the first Amipaque myelography.