Steroid suppression of meningeal inflammation caused by Pantopaque

Corticosteroid therapy of experimental hydrocephalus after intraventricular-subarachnoid haemorrhage

“…It has been suggested that this inflammatory response to the presence of blood in CSF also may be an important part of the mechanism of obstruction in the acute phase of post-SAH hydrocephalus. Fibrous adhesions causing permanent obstruction develop late in the subarachnoid space, with significant scar production requiring more than four weeks to develop (Schemm et al, 1968 (Smith and Ross, 1959;Sehgal et al, 1962;Mack, 1964;Kulick, 1965 The effectiveness of adrenocorticosteroids in lessening the incidence of significant hydrocephalus after subarachnoid haemorrhage in this study relates presumably to their known antiinflammatory effect. Their possible effect on long-term evolution of fibrous scarring of subarachnoid pathways or arachnoid villi remains conjectural (and will form the basis for continued studies).…”

“…One long-acting steroid preparation, methylprednisolone acetate (Depomedrol, Upjohn Co.) has been used intrathecally to provide a high CSF concentration in non-infectious inflammatory diseases of the arachnoid membrane-adhesive arachnoiditis, nerve root fibrosis, etc. (Smith and Ross, 1959;Sehgal et al, 1962;Mack, 1964;Kulick, 1965). Since the arachnoid villi are actually extensions of the arachnoid membrane, the treatment in similar fashion of an inflammatory disease of the villi caused by blood in the CSF would seem to be a logical adjunctive measure in an attempt to prevent symptomatic hydrocephalus after SAH.…”

Prevention of Postmyelographic and Postpneumoencephalographic Headache by Single Dose Intrathecal Methyl‐prednisolone Acetate

“…This has also been well documented following use of Pantopaque. 37 Thus it is not surprising to see reports of transient CSF pleocytosis resulting from repeated instillation of Depo-Medrol into the lumbar theca. 43,44 In this regard, however, it is of note that Goldstein, McKenzie and McGuckin 45 report decrease in lymphocytosis without appearance of polymorphonuclear leucocytes during serial intrathecal Depo-Medrol injections in multiple sclerosis patients.…”