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Rudehill A, Gordon E, Grepe A, Widén L. The epileptogenicity of neurolept anaesthesia in patients during and after neuroradiological examinations with metrizamide. Acta Anaesthesiol Scand 1983; 27:285-8. [PMID: 6637352 DOI: 10.1111/j.1399-6576.1983.tb01952.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Previous experimental studies caution against the use of neurolept anaesthesia during subarachnoid injection of metrizamide for neuroradiodiagnostic procedures because of severe epileptogenic complications. To examine whether these recommendations are relevant in the clinical situation or not, 104 patients were studied. They underwent neuroradiological investigations with metrizamide subarachnoidally and were anaesthetized with neurolept anaesthesia either during the investigation (59 patients, Group I) or within 48 h afterwards (45 patients, Group II) when a neurosurgical operation was performed. In 10 patients of Group I, EEG was recorded during the investigation. All patients were observed for occurrence of clinical epileptic manifestations during and after the anaesthesia. Apart from one patient who had a short episode of suspected epileptogenic EEG-activity shortly after the injection of metrizamide, none of the other patients showed EEG-abnormalities of epileptogenic type and none of them had any clinical signs of epileptic manifestations. On the basis of the results of this clinical study it is concluded that neurolept anaesthesia does not increase the risk of epileptic complications during neuroradiological investigations with metrizamide.
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Thurtle OA, Cleur KA, Cawley MI. Myelography--a case for audit. Clin Rheumatol 1983; 2:57-60. [PMID: 6236016 DOI: 10.1007/bf02032069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The radiographic findings and clinical outcome of 54 patients having a myelogram at the request of the Department of Rheumatology over a period of five years are described. Fortynine of the patients had either clinical features of an intervertebral disc protrusion or chronic back pain of obscure aetiology. Abnormalities which could have accounted for the symptoms and signs were found in 28 of these. Although useful information was obtained in regard to therapy the investigation did not lead to surgical treatment in any of the patients without clinical evidence of lumbar root compression. No unexpected malignancies were found. Morbidity was common, but usually mild.
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Taminiau AH, Slooff TJ. Bilateral femoral neck fractures as a complication of myelography. ACTA ORTHOPAEDICA SCANDINAVICA 1980; 51:621-4. [PMID: 7446051 DOI: 10.3109/17453678008990852] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
This paper discusses two cases of bilateral subcapital fracture of the proximal femur as a complication of myelography with Conray 60. The literature is reviewed.
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Hatten HP. Metrizamide lumbar epidurography with Seldinger Technique through the sacral notch and selective nerve root injection. Neuroradiology 1980; 19:19-25. [PMID: 7354912 DOI: 10.1007/bf00369083] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Lumbar epidurography serves as an important radiographic procedure in the evaluation of patients with equivocal myelography and confusing or non-diagnostic physical findings. It is particularly valuable in patients with a wide ventral epidural space secondary to previous surgery, arachnoiditis or on a congenital basis. Several techniques and various contrast agents have been employed for the procedure. A pure Seldinger technique with a caudal approach through the sacral hiatus and injection of metrizamide gives excellent visualization of the epidural space and nerve root sleeves. The proper concentration of metrizamide is crucial for optimal results. Lateral, AP, and AP oblique radiographs, occasionally combined with lateral, complex motion tomography, clearly demonstrate the root sleeves and ventral epidural space. CT scanning, with present technology, does not provide the necessary detail for evaluating the epidural space.
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Cook PL, Wise K. A correlation of the surgical and radiculographic findings in lumbar disc herniation. Clin Radiol 1979; 30:671-82. [PMID: 509869 DOI: 10.1016/s0009-9260(79)80019-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The findings on plain radiographs and at water-soluble radiculography are compared with those at laminectomy in 50 patients with lumbar disc protrusions. Predictions of the level of disc protrusion based on the plain radiographic appearances could be made in 71%. Water-soluble radiculography accurately demonstrated 50 of 52 protrusions (96%). No abnormality was found at surgery at three other disc levels where equivocal radiculographic appearances failed to eliminate the possibility of disc protrusion. When all the levels examined surgically are included the water-soluble radiculogram was accurate at 57 levels out of 62 (92%). The immediate morbidity of radiculography is described and significant side effects were shown by 23% of patients.
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Cottrall MF. Book reviewRadiopharmaceutical dosimetry symposium. Edited and compiled by CloutierR. J., CoffeyJ. L., SnyderW. S. & WatsonE. E., pp. ix + 518, 1978 (U.S. Department of Health, Education and Welfare, Maryland) $6.20. Br J Radiol 1978. [DOI: 10.1259/0007-1285-51-605-327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Hansen EB, Fahrenkrug A, Praestholm J. Late meningeal effects of myelographic contrast media with special reference to metrizamide. Br J Radiol 1978; 51:321-7. [PMID: 638401 DOI: 10.1259/0007-1285-51-605-321] [Citation(s) in RCA: 34] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Two hundred and fifty-six myelograms in 192 patients were following by repeat myelography using a water-soluble contrast medium. The films of these re-examinations were analysed for signs of meningeal changes. Adhesive arachnoiditis had developed in five of 46 cases after methiodal sodium, in 24 of 96 cases after iothalamate meglumine, in seven of 12 cases after iocarmate meglumine, in seven of ten cases after iodophendylate, but in none of 90 cases after metrizamide. Dose of contrast medium, observation time and protein concentration of the CSF were found to be factors of importance for the development of adhesive arachnoiditis.
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Hale BT. Book reviewDermatologic Radiotherapy. By Braun-FalcoO., GoldschmidtH. and LukacsS., pp. xiv+154, illus., 1976 (Springer Verlag), DM.35·40. Br J Radiol 1978. [DOI: 10.1259/0007-1285-51-603-202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Johnson AJ, Burrows EH. Thecal deformity after lumbar myelography with iophendylate (Myodil) and meglumine iothalamate (Conray 280). Br J Radiol 1978; 51:196-202. [PMID: 630188 DOI: 10.1259/0007-1285-51-603-196] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
A study of repeat myelograms carried out in 93 patients revealed that the incidence of thecal scarring following Conray lumbar radiculography is high (61% of all cases), and only slightly lower than that found after Myodil myelography (74%). Possible factors affecting the incidence of arachnoiditis and the radiological and clinical significance of this condition are considered.
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Abstract
An experimental method for testing contrast media for myelography was developed and used to compare three watersoluble contrast media, iocarmate meglumine, iothalamate meglumine and metrizamide after suboccipital myelography in 120 rabbits. A further 71 rabbits served as controls. Iocarmate and iothalamate caused vigorous convulsions; metrizamide did not. Examination of the CSF revealed an acute pleocytosis after installation of the contrast media and after cisternal puncture with injection of hypertonic saline. Histological examination of the spinal cord, nerve roots and meninges revealed pathological changes in 1 or 32 unoperatec controls (3%). Leucocyte infiltrations were found in the meninges, nerve roots and spinal cord of about 20% of the animals after myelography, after cisternal puncture without injection or with injection of hypertonic saline. There were no significant quantitative differences between the experimental groups. Degenerative changes were seen only after myelography. No meningeal fibrosis was demonstrated. An abnormal leucocyte count in the primary CSF influenced the incidence of histological changes, indicating that only rabbits with CSF cell counts within normal limits should be used in future experiments.
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Abstract
In contradistinction to all currently available water-soluble contrast media, metrizamide (Amipaque) is not a salt, but a substituted amide and therefore does not dissociate in solution. This unique property results in solutions of high iodine content yet with low osmolality. Metrizamide probably has a lower neurotoxicity than any other known water-soluble contrast agent. A clinical trial of metrizamide lumbar myelography in 201 patients in three clinical centres represents the first clinical assessment of this new contrast medium in the United Kingdom. The technique of the radiological procedure and the adverse reactions encountered are presented and discussed. There were no serious adverse effects: no muscle spasm or epilepsy. Minor adverse reactions--headache, vomiting and nausea occur with approximately the same frequency as with meglumine iocarmate: 43 percent of patients complained of headache. In 118 patients, the lower dorsal subarachnoid space was also examined with no increase in toxic reactions. It is concluded that metrizamide is a safe contrast medium for lumbar and lower dorsal myelography. Water-soluble media will probably largely replace oil products for these investigations. Further clinical trials are being extended to include examination of the upper dorsal and cervical subarachnoid space.
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Hansen EB, Praestholm J, Fahrenkrug A, Bjerrum J. A clinical trial of Amipaque in lumbar myelography. Br J Radiol 1976; 49:34-8. [PMID: 776316 DOI: 10.1259/0007-1285-49-577-34] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
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.
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Abstract
In a comparative study between Dimer X and Amipaque (metrizamide) for lumbar myelography it was found that there is a little higher frequency of monor, but unimportant side effects after Amipaque. Amipaque has also been used for thoracocervical myelography with excellent results and without greater discomfort than after myelography in the lumbar region. A new puncture technique was used for the eximation of the cervical region alone: lateral puncture on the neck between the laminae of C1 and C2 under TV control. In more than 75 reinvestigations no arachnoid changes were observed.
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Hindmarsh T, Grepe A, Widén L. Metrizamide-phenothiazine interaction. Report of a case with seizures following myelography. ACTA RADIOLOGICA: DIAGNOSIS 1975; 16:129-34. [PMID: 810000 DOI: 10.1177/028418517501600204] [Citation(s) in RCA: 39] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
One single clinical complication of grand mal seizures in conjunction with the subarachnoid administration of the new non-ionic contrast medium metrizamide is reported in a patient who had been taking chlorpromazine. An interaction between the contrast medium and phenothiazine derivatives is considered probable.
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Slätis P, Autio E, Suolanen J, Norrbäck S. Hyperosmolality of the cerebrospinal fluid as a cause of adhesive arachnoiditis in lumbar myelography. ACTA RADIOLOGICA: DIAGNOSIS 1974; 15:619-29. [PMID: 4463698 DOI: 10.1177/028418517401500604] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Ahlgren P. Long term side effects after myelography with watersoluble contrast media: Conturex, Conray Meglumin 282 and Dimer-X. Neuroradiology 1973; 6:206-11. [PMID: 4772444 DOI: 10.1007/bf00335325] [Citation(s) in RCA: 34] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Skalpe IO. Myelography with metrizamide, meglumine iothalamate and meglumine iocarmate. An experimental investigation in cats. ACTA RADIOLOGICA. SUPPLEMENTUM 1973; 335:57-66. [PMID: 4534578 DOI: 10.1177/0284185173014s33508] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Sawhney BB, Oftedal SI. Reactions to suboccipital injection of water-soluble contrast media in rabbits. ACTA RADIOLOGICA. SUPPLEMENTUM 1973; 335:67-83. [PMID: 4377905 DOI: 10.1177/0284185173014s33509] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Skalpe IO, Torbergsen T, Amundsen P, Presthus J. Lumbar myelography with metrizamide. ACTA RADIOLOGICA. SUPPLEMENTUM 1973; 335:367-79. [PMID: 4534574 DOI: 10.1177/0284185173014s33545] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Abstract
Conray-280 (meglumine iothalamate) can be injected safely into the cisterna magna in the human. In this series of 46 patients no complications were encountered attributable to the irritant effects of Conray. Satisfactory radiographic visualization was obtained in 87% of cases using 5 ml. 50% solution of Conray-280 enabling clear delineation of the anterior and posterior borders of the spinal cord to be made.
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Haase J, Jepsen BV, Bech H, Langeback E. Spinal fracture following radiculography using meglumine iothalamate (Conray). Neuroradiology 1973; 6:65-70. [PMID: 4788980 DOI: 10.1007/bf00399810] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Kosary IZ, Tadmor R, Ouaknine G, Braham J. Lumbosacral myelography with Dimer-X. Report of 100 cases. J Neurosurg 1973; 39:359-61. [PMID: 4733434 DOI: 10.3171/jns.1973.39.3.0359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
✓ The authors report the use of the water-soluble spinal contrast medium Dimer-X in 100 cases of suspected lumbar disc disease. It was particularly valuable in delineating small laterally-placed protrusions causing root compression, which are often difficult to demonstrate with oily contrast media. Side effects were mild and transient, and no serious complications were encountered.
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Halaburt H, Lester J. Leptomeningeal changes following lumbar myelography with water-soluble contrast media (meglumine iothalamate and methiodal sodium). Neuroradiology 1973; 5:70-6. [PMID: 4363536 DOI: 10.1007/bf00337486] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Praestholm J, Olgaard K. Comparative histological investigation of the sequelae of experimental myelography using sodium methiodal and meglumine iothalamate. Neuroradiology 1972; 4:14-9. [PMID: 4343065 DOI: 10.1007/bf00344803] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Picaza JA, Hunter SE, Lee L. Seizures associated with the use of meglumine iothalamate 60 per cent in ventriculography. J Neurosurg 1972; 36:474-80. [PMID: 4536861 DOI: 10.3171/jns.1972.36.4.0474] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
✓ Meglumine iothalamate 60% (Conray) is a water-soluble substance being developed for the roentgenographic visualization of the cerebral ventricular system. Although it offer definite advantages compared to other contrast media, a recognized disadvantage is the possible development of seizures. This complication seems to be relatively rare and largely preventable, but once present may seriously endanger the patient's life. It appears to be a neurotoxic phenomenon, resistant to the usual anticonvulsant medications, and requires the availability of sophisticated personnel and emergency procedures to prevent death.
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Praestholm J, Lester J. Complications of myelography with conray meglumin. ACTA RADIOLOGICA: DIAGNOSIS 1972; 13:860-4. [PMID: 4679493 DOI: 10.1177/02841851720130p244] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Lehtinen E, Seppänen S. Side effects of Conray Meglumin 282 and Dimer-X in lumbar myelography. ACTA RADIOLOGICA: DIAGNOSIS 1972; 12:12-6. [PMID: 5021464 DOI: 10.1177/028418517201200103] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Autio E, Suolanen J, Norrbäck S, Slätis P. Adhesive arachnoiditis after lumbar myelography with meglumine iothalamate (Conray). ACTA RADIOLOGICA: DIAGNOSIS 1972; 12:17-24. [PMID: 5021465 DOI: 10.1177/028418517201200104] [Citation(s) in RCA: 35] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Skalpe IO. Lumbar myelography with Conray Meglumin 282. Report of 100 investigations with special reference to the adverse effects. Acta Neurol Scand 1971; 47:569-78. [PMID: 4334470 DOI: 10.1111/j.1600-0404.1971.tb07509.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Occleshaw JV, Holyland JN. Comparative study of the effects of Conray 280 and Dimer X in lumbar radiculography. Br J Radiol 1971; 44:946-8. [PMID: 5156916 DOI: 10.1259/0007-1285-44-528-946] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
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Wright FW, Sanders RC, Steel WM, O'Connor BT. Some observations on the value and techniques of myelography in lumbar disc lesions. The results over a five year period at the Nuffield orthopaedic centre, Oxford. Clin Radiol 1971; 22:33-43. [PMID: 4323920 DOI: 10.1016/s0009-9260(71)80007-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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