Subdural injection of contrast medium as a complication of myelography

Penderis, Jacques; Sullivan, Martin; Schwarz, Tobias; Griffiths, I. R.

doi:10.1111/j.1748-5827.1999.tb03785.x

Cited by 17 publications

(14 citation statements)

References 9 publications

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“…White denticulate ligaments (arrows) anchor the pia and spinal cord to the dura; they also restrict ventral extension of the ink within the subdural space (from Penderis et al, 1999).…”

Section: 11mentioning

confidence: 99%

Functional anatomy

Sharp

2005

Small Animal Spinal Disorders

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“…White denticulate ligaments (arrows) anchor the pia and spinal cord to the dura; they also restrict ventral extension of the ink within the subdural space (from Penderis et al, 1999).…”

Section: 11mentioning

confidence: 99%

Functional anatomy

Sharp

2005

Small Animal Spinal Disorders

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“…Practitioners should become aware of the expectable limited cephalocaudal extent of normal contrast flow when using small volumes (0.3–0.5 mL) of injected contrast. While the posterior outline of the injected subdural contrast may be linear due to the dura mater, the anterior border, if opacified by contrast, may appear irregular due to the arachnoid mater [19, 20]. Given identical volumes of contrast injection, the density of the subdural contrast will be far greater due to dilution of intrathecal contrast by CSF [19].…”

Section: Discussionmentioning

confidence: 99%

Inadvertent Subdural Injection during Cervical Transforaminal Epidural Steroid Injection

Sadacharam

Petersohn

Green

2013

Case Reports in Anesthesiology

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Serious complications following cervical epidural steroid injection are rare. Subdural injection of local anesthetic and steroid represents a rare but potentially life threatening complication. A patient presented with left sided cervical pain radiating into the left upper extremity with motor deficit. MRI showed absent lordosis with a broad left paramedian disc-osteophyte complex impinging the spinal cord at C5-6. During C5-6 transforaminal epidural steroid injection contrast in AP fluoroscopic view demonstrated a subdural contrast pattern. The needle was withdrawn slightly and repositioned. Normal lateral epidural and nerve root contrast pattern was subsequently obtained and injection followed with immediate improvement in radicular symptoms. There were no postoperative complications on subsequent clinic follow-up. The subdural space is a potential space between the arachnoid and dura mater. As the subdural space is larger in the cervical region, there may be an elevated potential for inadvertent subdural injection. Needle placement in the cervical subdural space during transforaminal injection is uncommon. Failure to identify aberrant needle entry within the cervical subdural space may result in life threatening complications. We recommend initial injection of a limited volume of contrast agent to detect inadvertent subdural space placement.

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“…7-9 Subdural collection of contrast appears more opaque than does contrast in the subarachnoid space, owing to the lack of dilution by CSF. 9 Failed spinal anesthesia has been reported in the medical literature, with 2 large prospective studies citing incidences of 3.1% 10 and 4%. 11 Subdural injection has been proposed as an explanation for a portion of failed spinal anesthesia.…”

Section: Discussionmentioning

confidence: 99%