Aseptic Meningoencephalitis after Iopamidol Myelography

Berod, T.; Knebelmann, O; Marjou, F

doi:10.1177/106002809302700923

Cited by 11 publications

(7 citation statements)

References 3 publications

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“…5 Since this review paper, six cases of clinically evident aseptic meningitis have been reported following the use of iohexol (n ϭ 3), iopamidol (n ϭ 2), or iotrolan (n ϭ 1) for myelography. [1][2][3][6][7][8] Initial CSF findings in these six cases (10,090 Ϯ 11,513 cells/cmm; 453 Ϯ 482 mg/dL total protein) were similar to our patient and indistinguishable from findings in bacterial meningitis.…”

Section: Discussionsupporting

confidence: 74%

Severe symptomatic aseptic chemical meningitis following myelography

Bender¹,

Elstner²,

Paul³

et al. 2004

Neurology

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Symptomatic aseptic, chemical meningitis is a rare complication of myelography. Its acute clinical course and standard laboratory findings are indistinguishable from those of bacterial meningitis. The authors present a case of severe postmyelographic chemical meningitis and compare CSF and serum inflammatory markers to a group of seven patients with proven bacterial meningitis. As in viral meningitis, procalcitonin might be able to discriminate between bacterial and chemical causes of CNS inflammation.

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Section: Discussionsupporting

confidence: 74%

Severe symptomatic aseptic chemical meningitis following myelography

Bender¹,

Elstner²,

Paul³

et al. 2004

Neurology

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“…The pathophysiology for the development of neurotoxicity from intrathecal nonionic contrast injections is not well understood but has been linked to osmolarity disturbances [ 15 ], lipid solubility [ 16 ], or even direct toxicity [ 17 ] of these agents.…”

Section: Discussionmentioning

confidence: 99%

Vasogenic Cerebral Edema following CT Myelogram with Nonionic Omnipaque 300

Khodor

Blumenthal

2018

Case Reports in Neurological Medicine

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Computed Tomography (CT) with myelogram is a relatively safe procedure. It requires the use of nonionic contrast agents which, unlike ionic contrast agents, have been associated with low complication rates. We report a case of a 69-year-old female who developed diffuse bilateral cerebral edema following a lumber myelogram with the use of intrathecal nonionic contrast agent Omnipaque (Iohexol) 300. We were able to find one other reported case of cerebral edema following the use of intrathecal nonionic contrast agent in the literature.

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“…Animal experimental and preliminary clinical reports show that metrizamide (Amipaque) which was introduced in 1969 as the first nonionic water soluble contrast, is less toxic in the subarachnoid space than commercially available water-soluble contrast media (9, 15). Current theories of the pathophysiology of neurotoxicity due to intrathecal use of nonionic contrasts include direct neurotoxicity (16), serum osmolarity differences, (10) and lipid solubility of the agent (17). We believe that the mechanism of acute onset of massive cerebral edema in our patient was the injection of high dose of Meglumine (14 mL) and dysfunction of the patient’s BBB, with subsequent loss of autoregulation of cerebrovascular blood flow which leads to vasogenic brain edema; and we emphasise that immediate recognition of a mistake and prompt aggressive treatment was life saving.…”

Section: Discussionmentioning

confidence: 99%

Incidental Intrathecal Injection of Meglumine Diatrizoate

Mansour

Abbas

Sabetian

et al. 2014

Iran Red Crescent Med J

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Introduction:Myelograghy is a process of instilling contrast medium to the subarachnoid space for evaluating the spinal column by radiography. There are various contrast solutions for different radiographic studies but not all of them are suitable for spinal column evaluation.Case Presentation:Our patient was a 60-year-old man who developed severe pain, tonic clonic convulsions and cardiopulmonary arrest after intrathecal injection of 14 mL of meglumine diatrizoate during an elective myelography procedure. Many of these cases would die or suffer from permanent sequelae if appropriate treatment is not received.Conclusions:Our subject recovered completely without any sequelae after receiving appropriate treatment in a multidisciplinary intensive care unit.

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Aseptic Meningoencephalitis after Iopamidol Myelography

Cited by 11 publications

References 3 publications

Severe symptomatic aseptic chemical meningitis following myelography

Severe symptomatic aseptic chemical meningitis following myelography

Vasogenic Cerebral Edema following CT Myelogram with Nonionic Omnipaque 300

Incidental Intrathecal Injection of Meglumine Diatrizoate

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