Syringomyelia caused by intrathecal remnants of oil-based contrast medium

Abstract

<jats:p>✓ Oily contrast medium had been in use since the early 19th century as a radiographic agent for detecting spinal lesions and spinal cord tumors until the late 20th century. At that point computed tomography scanning and magnetic resonance imaging, or other hydrophilic contrast medium substituted for it. Adverse effects of oil-based dye, both acute and chronic, had been reported since the middle of the 20th century. In this paper the authors report the case of syringomyelia that seemed to be caused mainly by remaining oily contrast medium for 44 years.</jats:p> <jats:p>Syringomyelia secondary to adhesive arachnoiditis caused by oily contrast medium after a long period of time is well known. In the present case, however, surgery revealed only mild arachnoiditis at the level of syringomyelia as well as both solid and liquid remnants of contrast medium.</jats:p> <jats:p>Generally, cerebrospinal fluid (CSF) blockage due to an arachnoid adhesion is considered to cause syringomyelia following adhesive arachnoiditis. The authors speculated that in the present case syringomyelia was induced by a mechanism different from that in the previously reported cases; the oily contrast medium itself seems to have induced the functional block of CSF and impaired the buffer system of the intrathecal pressure. No reports on thoracic adhesive arachnoiditis and syringomyelia caused by oil-based dye referred to this mechanism in reviewing the literature.</jats:p>

Cervical Central Canal Occlusion Induces Noncommunicating Syringomyelia

“…12,[14][15][16][17]36,50,51 To test this hypothesis, Cho et al 13 injected kaolin into the subarachnoid space in the vicinity of a SCI in rabbits to evaluate the contribution of adhesive arachnoiditis in producing PTS. However, uncontrolled kaolin diffusion through the subarachnoid space above and below the SCI occurred in that study; therefore, a standard, reproducible animal model was not produced.…”

“…[1][2][3][4][5][6][7][8][9][10][11] Arachnoiditis [12][13][14][15][16][17] and central canal (CC) occlusion (CCO) 5,[18][19][20][21][22][23] are considered to be major factors causing the expansion of cysts in noncommunicating SM not associated with a Chiari malformation.…”

Normal Pressure Hydrocephalus Following Myodil Myelography

“…Some cases of obstructive hydrocephalus, thoracic arachnoiditis as well as syringomyelia in the late period after myodil myelography were described in literatures. 3,4 In our case, normal pressure hydrocephalus (NPH) was developed secondary to the myelography using myodil performed 25 years ago.…”

“…2 Acute complications may occur after use of myodil, while chronic complications may develop years after. [1][2][3][4] This contrast media can be detected in the thecal sac even many years after myelography due to its remarkably slow absorption. 1 Long- Fig.…”

Asymptomatic thoracic Pantopaque cyst mimicking an intradural extramedullary lipoma on MR images

“…There were many variations between cases and they are summarized in Table 1. In some cases, multiple enhancements were noted [3][4][5]. Secondary anatomical changes, such as syrinx [2,5,6] or arachnoid cysts or fluid-fluid level forming cysts [6,7], and clumping of the nerve roots due to arachnoiditis were also reported.…”