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PubMed1979

Adverse side effects of metrizamide in myelography.

The adverse side effects in a series of 439 myelographies with metrizamide were analyzed. The most frequent side effect was headache, which could be differentiated as early onset headache, related to hydrodynamic modifications in the spinal fluid following lumbar puncture, and late onset headache related to a metrizamide effect. The frequency of late onset headache was at least 27%, but all together 46% of the patients had postmyelographic headache. Meningeal irritation was seen in 5%, sometimes in a severe form, mimicking a septic complication. Spinal irritation and epileptic fits were rarely seen. Striking was the occurrence of an acute psycho-organic syndrome, frequently observed after cervical myelography which was performed with a higher than usual dose of iodine. We can not confirm the general opinion that the central nervous system had a good tolerance for metrizamide.

Anaphylaxis↗
PubMed1987

Side effects after diagnostic lumbar puncture and lumbar iohexol myelography.

A prospective, controlled study was performed to compare side effect incidences after lumbar iohexol myelography (n = 97) and diagnostic lumbar puncture (n = 85). No significant side effect incidence differences (iohexol vs. controls) were found regarding number of patients with any side effect (63 vs. 73%), headache (44 vs. 54%), nausea, dizziness, visual, auditory, or psychic symptoms. Early-onset headache occurred significantly more often in the iohexol group (17 vs 5%), while postural headache occurred most frequently after lumbar puncture (25 vs. 41%). These results suggest that apart from the slight early-onset headache, most side effects after lumbar iohexol myelography are related to the puncture per se, not to the contrast agent.

Adult↗
PubMed1978

The value of radionuclide myelography in the evaluation of spinal arachnoiditis.

On the basis of myelographic findings, spinal adhesive arachnoiditis was classified into three types: type I (peripheral or marginal), type II (central), and type III (advanced). Depending on its location and extent, it may be divided into group A (lumbar), group B (thoracic), and group C (cervical). In view of the fact that intrathecal injection both of oily and of water-soluble contrast media tends to produce spinal arachnoiditis, we have been using radionuclides for pre- and postoperative myelography to evaluate arachnoiditis. Radionuclide myelography with 131I-HSA or 111In-DTPA is a safe modality which provides useful information regarding spinal arachnoiditis.

Adult↗
PubMed1978

Amipaque myelography without late adhesive arachnoid changes.

Sixty-three myelographies were performed with Amipaque. Remyelography after an interval of longer than 2 months showed that in one case there was progression of an arachnoiditis which had already been present during the first Amipaque study. In one other case there were minimal, unilateral nerve root changes caused by an intervening operation. Altogether 269 remyelographies without secondary late reactions are registered. Two cases of increased arachnoid changes from a previous myelography with another contrast medium hardly can be due to Amipaque.

Adult↗
PubMed1978

Myelography in Guillain-Barré syndrome (acute inflammatory polyradiculoneuropathy).

The Guillain-Barré syndrome has been studied by lumbar myelography with watersoluble contrast media in seven cases. Abnormalities, which consisted of widening of the nerve roots and obliteration of the root sleeves, were found in three of them. It is possible that myelography accentuated the symptoms in one case while the rest tolerated the examination well.

Adult↗
PubMed1986

A comparison of computed tomography and myelography in the diagnosis of lumbar disc herniation.

Ninety patients suspected to have a herniated lumbar disc were examined by myelography and computed tomography (CT). Of these, 37 were subjected to surgery. The surgical findings were in agreement in 21 patients (57%) with the myelograms and in 28 patients (76%) with the CT examinations. False-positive CT examinations were found in only one patient. CT is as reliable as myelography in the primary diagnosis of disc herniation.

Adult↗
PubMed1993

The contribution of needle size and other factors to headache following myelography.

The author performed a randomized prospective study of the effects of needle size and of age, sex, myelogram type and operators on the incidence of headache following myelography. In 113 patients randomized to 22 G and 25 G needle groups, data were obtained by questionnaire on the frequency of headache up to five days following the procedure. The influence of needle size was statistically insignificant (63%, 48%, p > 0.05). Age (p = 0.0002), sex (p = 0.01), myelogram type (p = 0.002) and myelographer (p = 0.03) significantly affected the frequency of headache. The size of the dural perforation appears to be less important than factors relating to age, sex, myelogram type and individual myelographers in the development of headache after myelography.

Adult↗
PubMed1993

Headache after lumbar iohexol myelography: the influence of a history of headaches and early ambulation.

Whether a history of headache or "early" versus "late" ambulation (no bed rest or bed rest for 24 h) influence the occurrence of headache after lumbar iohexol myelography was studied by blinded interviews in 158 consecutive patients referred for elective lumbar myelography (LM) because of suspected lumbar disc prolapse or spinal stenosis. Headache after LM occurred more often in patients with a history of headache (57%) than in patients without such a history (29%), P < 0.001. Patients with normal myelographic findings complained of headache after LM more often (55%) than patients with abnormal myelograms (31%), P < 0.008. No difference in the incidence of headache after LM was demonstrated in early versus late ambulation.

Adolescent↗
PubMed1993

Status epilepticus following iohexol myelography.

Iohexol, a contrast medium widely used for myelography, has rarely been reported to cause convulsive disorders. A case of status epilepticus resulting from iohexol myelography is reported and problems of treatment are discussed.

Adult↗
PubMed1996

Two-dimensional MRI at 1.5 and 0.5 T versus CT myelography in the diagnosis of cervical radiculopathy.

A prospective comparison was made of standard two-dimensional MRI sequences, at both high and midfield strength, with CT myelography in 23 patients with cervical spondylosis. MRI is adequate for assessment of cord compression, where high field strength is superior to midfield strength. MRI using 4-mm sections is inadequate for presurgical assessment of root compression. It remains to be proven whether thin-section white-CSF volume sequences or gadolinium-enhanced volume studies can replace CT myelography.

Adult↗
PubMed1997

Acute hydrocephalus after iotrolan lumbar myelography.

A 33-year-old woman with cryoglobulinaemia developed acute hydrocephalus 20 h after lumbar myelography using the water-soluble contrast medium iotrolan. After a ventricular drainage, she was free of symptoms and the hydrocephalus resolved. The development of acute hydrocephalus after myelography has not been reported previously.

Acute Disease↗
PubMed2000

Needle diameter in outpatient myelography: rates of adverse effects and current practice trends.

Telephone calls were made to 1251 consecutive patients one day following outpatient myelography. Data were available on 518 patients punctured with 22-gauge (g) (large-diameter) and 465 with 25-g (small-diameter) spinal needles. We surveyed 48 academic and private practice groups regarding needle diameter use in myelography; data were obtained from 34 private practice and 14 academic radiology departments. Patients reported adverse effects including mild and severe headache, back pain and nausea. The percentage of total adverse effects was significantly greater in the 22-g than in the 25-g needle group. The percentage of patients with headache was higher in the 22-g than in the 25-g group, but this difference was not statistically significant. Only 19% of private practice groups and 17% of academic centers use 25-g needles; the remainder use 20-g or 22-g needles.

Adult↗
PubMed1998

Quantitative measurements of the spinal cord and canal by MR imaging and myelography.

There is a large individual variation in human spinal cord and canal size, even in patients of different series studied by the same modality, and no authorized standard method has been established. A comparative study of sagittal diameters of the cervical spinal cord and canal using myelography and MRI is presented. The purposes of this paper are (a) to establish the correction factor (CF) needed for quantitative comparison of the two imaging modalities, and (b) to determine the different factors that may modify the measurement of these diameters. We studied 45 patients with clinical findings compatible with cervical spondilotic myelopathy. In our experience, the CF for accurate correlation of MRI and myelography measurements is 1.32 and depends almost entirely on the radiographic geometry of the myelographic procedure. In addition, there is a variability in the group of MRI results due to imprecision of the pressure-pad measuring/input device of the instrument itself and the sequence performed.

Adult↗
PubMed2001

Comparison in myelography between iodixanol 270 and 320 mgI/ml and iotrolan 300 mgI/ml: a multicentre, randomised, parallel-group, double-blind, phase III trial.

The objective of the trial was to compare the safety and efficacy of the non-ionic, dimeric, isotonic contrast medium iodixanol (Visipaque 270 and 320 mgI/ml) with those of iotrolan (Isovist 300 mgI/ml) in myelography. After lumbar or cervical puncture, 315 patients were examined in a multicentre, double-blind, randomised, comparative myelography study. Image quality, changes in vital signs, immediate and delayed adverse events were registered. There was a tendency for better images with iodixanol 320 than with iodixanol 270 and iotrolan 300, but the overall quality was good or excellent with all products. The frequency of patients reporting adverse events and headache varied much across centres, but there was no statistically significant difference between the contrast media. The incidence of events was higher after lumbar puncture than after cervical puncture, in women rather than in men, and after puncture with a 22-gauge (G) bevel-tipped needle compared with a 24 G Sprotte needle. The frequency of headache did not correlate with the absence of pathology. The higher iodine concentration in iodixanol 320 could be an advantage for film quality. When compared with iotrolan 300, iodixanol 320 and 270 give similar incidences of adverse events, including headache.

Contrast Media↗
PubMed1983

Acute chemical meningitis after metrizamide-lumbar myelography.

Severe acute meningitis developed after the use of metrizamide for lumbar myelography; cerebrospinal fluid findings included a white blood cell count of 2300, mostly polymorphonuclear cells, glucose level of 8 mg% and protein level of 253%. This apparent chemical meningitis could not be distinguished, either clinically or by cerebrospinal fluid examination, from acute bacterial meningitis. This case emphasizes that severe acute meningeal reactions, while very rare, can occur after the use of metrizamide for myelography. Such patients must be evaluated promptly to rule out bacterial meningitis and should be followed carefully for possible later sequelae.

Acute Disease↗
PubMed1983

Conjoined lumbosacral nerve roots. Diagnosis with metrizamide myelography.

The most common anomaly of the lumbosacral nerve roots consists of a composite root sleeve containing the roots for two spinal nerves. Before the advent of water-soluble myelography, this anomaly was rarely diagnosed except at operation. Metrizamide myelography readily demonstrates the anomaly because of improved filling of the root sleeves and greater definition of the nerve roots within the subarachnoid space. However, an underlying disk herniation may not be evident on the myelogram because of the unique anatomic configuration.

Adult↗
PubMed1983

Iopamidol in lumbar myelography.

Iopamidol is a new, nonionic, water-soluble contrast material currently undergoing clinical trials for intravascular and intrathecal use in Europe and the United States. In this study, 12 patients underwent lumbar myelography with this agent. For each subject, up to 12 mL of iopamidol (at 200 mg I/mL) was employed. The myelograms obtained were highly satisfactory. No serious adverse reactions were observed. The most common side effect--headache--occurred in seven patients. However, six of the seven headaches were mild and transient, and did not require treatment. Nausea occurred in two patients, back pain in two patients, hypotension and hypertension each in one patient. All of these reactions were mild and self-limited. Iopamidol appears to be a safe and conveniently used agent for lumbar myelography.

Adult↗
PubMed1988

Syringomyelia: myelography, computed tomography, and magnetic resonance imaging.

Seventeen patients with cervical spinal cord cavities were studied with myelography, postmyelographic computed tomography scanning, and magnetic resonance imaging. The three diagnostic techniques were compared for accuracy, patient comfort, and ease of procedure. Magnetic resonance imaging was the best diagnostic and most comfortable procedure. There is no need for myelography or postmyelographic computed tomography scanning for the evaluation of cervical syringomyelia.

Humans↗