Multiple subcortical haemorrhages following lumbar metrizamide myelography

Abstract

The case is presented of a patient showing multiple subcortical haemorrhages after lumbar metrizamide myelography. This complication after intrathecally administered metrizamide contrast medium appears not to have been reported before. Several different possible explanations are proposed for the phenomena observed in this case.

Intraparenchymal haemorrhage after evacuation of chronic subdural haematoma. Report of three cases and review of the literature

“…[4][5][6][7][8] At present, the most likely explanation for the onset of this complication is a sudden variation in cerebral blood flow as a consequence of cerebral decompression. [6][7][8]12,13 Indeed, intracerebral haemorrhage owing to a variation of the intracranial pressure gradient, has been reported even after lumbar puncture for myelography [15][16][17] or spinal analgesia, 18,19 after evacuation of an extracerebral fluid collection; 8 in other cases, it occurred postoperatively far from the site of craniotomy. [20][21][22] SPECT studies have demonstrated that cerebral blood flow in patients with chronic subdural haematoma is diminished, particularly in the homolateral basal ganglia and thalamus.…”

Bilateral Frontal Haemorrhages Associated with Continuous Spinal Analgesia

“…The majority of cases of intracerebral haemorrhage following dural tap are related to lumbar myelography [7][8][9][10] , which usually involves 20 or 21 gauge needles. Most of these cases presented with headache and the initial diagnosis was PDPH.…”

“…The most common complication is post dural puncture headache 1,2 , and less commonly subdural haematoma [3][4][5][6] . Intracerebral haemorrhage appears rare 1,[7][8][9][10][11] . We report a case of bilateral frontal haemorrhages following continuous spinal postoperative analgesia, an event not previously described in the literature.…”