Inadvertent intraoperative myelography with hypaque: Case report and discussion

Killeffer, James A.; Kaufman, Howard H.

doi:10.1016/s0090-3019(96)00156-5

Cited by 21 publications

(37 citation statements)

References 19 publications

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“…All patients (n=6) who were treated with active removal of the CM by intrathecal drainage/lavage survived, as in our case [7,10,11,12,22]. Different modes of intrathecal lavage have been described.…”

Section: Fig 2a Bmentioning

confidence: 68%

Inadvertent intrathecal use of ionic contrast agent

et al. 2002

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Intrathecal administration of ionic contrast media may cause severe and fatal neurotoxic reactions due to their hyperosmolarity and ionic nature. They are therefore strictly contraindicated for all radiologic applications involving the central nervous system (e.g., myelography). We present a case in which ioxitalamate was accidentally injected intrathecally. The patient recovered completely due to a combination of the different therapeutic options reported in the literature, including early mechanical ventilation and neuromuscular paralysis, aggressive control of seizures, elevation of head and trunk to prevent cephalad migration of contrast, steroids, cerebrospinal fluid drainage and lavage and prophylactic antibiotics.

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Section: Fig 2a Bmentioning

confidence: 68%

Inadvertent intrathecal use of ionic contrast agent

et al. 2002

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“…Later, ionic water-soluble media were developed. However, they are unsuitable for direct contact with neural tissue and the neurotoxicity and other complications of these agents like: severe muscle spasms, seizures, cerebral edema and hemorrhage, coma, paralysis, hypotension, hyperthermia, rhabdomyolysis, multisystem organ failure, and even death are well documented (11-14). Clonic convulsions of the lower extremities after intrathecal injection of meglumine iothalamate and meglumine iocarmate, have been reported by different authors and the possibility of late sequelae, due to adhesive arachnoiditis must be seriously considered (9).…”

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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“…There are two groups of radiocontrast media: ionic, hyperosmolar (1500 mOsm kg −1 ) or first‐generation solutions, and the newer, second‐generation, nonionic, hypo‐ and isoosmolar (350–700 mOsm kg −1 ) agents. It is widely accepted that the first generation radiocontrast medias are more toxic and more immunogenic and therefore responsible for a higher morbidity, including allergic reactions (4). Water‐soluble ionic media are soluble in cerebrospinal fluid and are metabolized from the thecal space but have propensity to cause spasms and convulsions when introduced intrathecally (5).…”

Section: Discussionmentioning

confidence: 99%

“…Prolonged paraplegia after iohexol myelography has been reported previously and the conduction block at the intrathecal radicular portion seems to indicate that these symptoms were caused by a direct neurotoxic effect attributable to iohexol (11). The onset of spasms occurs several hours after application of the ionic contrast agents to the spinal cord (4). In our case after iohexol myelography, a 2‐h delay was seen before the onset of extremity spasms.…”

Section: Discussionmentioning

confidence: 99%

Rhabdomyolysis after intraoperative myelography

Canbay

Bal

Akıncı

et al. 2004

Pediatric Anesthesia

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This case report suggests that the nonionic contrast agents may cause myoclonic spasms and seizures like the ionic ones. A 14-year-old female with congenital scoliosis was scheduled for T2-L3 scoliosis surgery. She had no medical history of a seizure disorder. After a negative wake-up test, myelography was performed with iohexol. Myoclonic spasms, disseminated intravascular coagulopathy (DIC) and rhabdomyolysis were diagnosed postoperatively. Anaesthesiologists should be aware of the complications which may occur after the use of nonionic and water-soluble contrast agents.

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Inadvertent intraoperative myelography with hypaque: Case report and discussion

Cited by 21 publications

References 19 publications

Inadvertent intrathecal use of ionic contrast agent

Inadvertent intrathecal use of ionic contrast agent

Incidental Intrathecal Injection of Meglumine Diatrizoate

Rhabdomyolysis after intraoperative myelography

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