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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty pediatric and 180 adult patients underwent myelography using metrizamide (Amipaque). All patients were examined and interviewed before and after the studies. New or exacerbated symptoms attributed to metrizamide myelography were graded according to severity. After the procedure, 51 of 200 patients were unchanged from baseline. Headache was the most common complaint, with an overall incidence of 62%. Nausea and/or vomiting occurred in 38%. Back or leg pain, neck stiffness, temperature elevation, and a variety of less common manifestations were also observed. The incidence of sequelae was higher than in comparable Scandinavian studies with this contrast medium.
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PMID:Sequelae of metrizamide myelography in 200 examinations. 41 57

Twenty-three cases suspected of skull base tumors were examined by CT cisternography (CTC) with CT scanner (EMI 1010) from April, 1977 to March, 1978. The lesions in 20 cases were diagnosed as positive and confirmed by operation and/or autopsies. These include five acoustic neurinomas, six pituitary adenomas, two craniopharyngiomas, two skull base meningiomas, one arachnoid cyst and miscellaneous tumors. Isotonic Metrizamide solution four of 2-10 ml was injected via lumbar route. Patients were kept in 30 degrees Trendelenburg position for 60 minutes until the first scanning. Scannings were obtained 1, 3, 6, 24 and in some cases 48 hours after lumbar injection. No side effects except for headache, nausea, vomiting occurred. There were no convulsions. In diagnosing cerebellopontine angle tumors, the indirect signs such as asymmetrical ambient cisterns are of importance, when combined with direct signs, i.e. a shadow defect. Parasellar tumors are usually difficult to diagnose with conventional CT due to streak artifact caused by adjacent bony structure. In CTC the extrasellar extension of pituitary tumors were clearly visible. The size, shape, dimensions and the relationship to the adjacent structures of the craniopharyngiomas were easily demonstrated with CTC especially when a coronal view was added. In arachnoid cyst, CTC demonstrated the delayed turnover of Metrizamide between the cyst cavity and the adjacent subarachnoid space. In conclusion, CTC is an useful neuroradiological diagnostic adjunct because of minimal bony streak artifact and high spatial resolution. It would be expected that small tumors of even 2-3 mm in diameter might be diagnosed, from the fact that the middle cerebral artery in the suprasellar cistern is clearly visible as a shadow defect.
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PMID:[Metrizamide CT cisternography in skull base tumors (author's transl)]. 41 46

Metrizamide (Amipaque; Winthrop) has provided consistently reliable diagnostic results in a small series of 150 myelograms. It is an acceptable diagnostic alternative to Dimer-X for myelography of the lumbar, thoracic and cervical segments. It is also safer but expensive, and its use requires modification of technique. The distressing headache which often follows lumbar puncture appears to be unavoidable.
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PMID:The use of metrizamide for myelography. 55 Apr 19

In contradistinction to all currently available water-soluble contrast media, metrizamide (Amipaque) is not a salt, but a substituted amide and therefore does not dissociate in solution. This unique property results in solutions of high iodine content yet with low osmolality. Metrizamide probably has a lower neurotoxicity than any other known water-soluble contrast agent. A clinical trial of metrizamide lumbar myelography in 201 patients in three clinical centres represents the first clinical assessment of this new contrast medium in the United Kingdom. The technique of the radiological procedure and the adverse reactions encountered are presented and discussed. There were no serious adverse effects: no muscle spasm or epilepsy. Minor adverse reactions--headache, vomiting and nausea occur with approximately the same frequency as with meglumine iocarmate: 43 percent of patients complained of headache. In 118 patients, the lower dorsal subarachnoid space was also examined with no increase in toxic reactions. It is concluded that metrizamide is a safe contrast medium for lumbar and lower dorsal myelography. Water-soluble media will probably largely replace oil products for these investigations. Further clinical trials are being extended to include examination of the upper dorsal and cervical subarachnoid space.
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PMID:Lumbar myelography with metrizamide-a new non-ionic contrast medium. 79 73

Metrizamide, a new water-solution iodinated contrast medium, was evaluated in 63 infants and children, most of whom had lumbosacral or low thoracic lesions. The diagnostic quality was found to be good, and no serious complications or permanent sequelae were encountered. Chief complications were headache, nausea, vomiting and fever. No myoclonic spasms or convulsions were seen. The advantages and disadvantages of metrizamide are discussed.
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PMID:Metrizamide in pediatric myelography. 87 81

This article is to present the experience in 1,000 cases given intrathecal Iohexol injection during 1985-1988, including conventional myelography in 343 cases, conventional and CT myelography in 572, only CT myelography in 60 and CT cisternography in 25. No convulsions were observed. The frequency of headache was 11.6% and the total uncomfortable subjective reaction was 19.6% after intrathecal injection, but no serious complications were found. Because of very low frequency of side effects after this injection, most of the examinations can be made in the outpatient departments. In our clinical experience, Iohexol appears to be a myelographic contrast medium with diagnostic capabilities and less morbidity compared to Metrizamide. Thus Iohexol seems to be well suited for intrathecal injection and will replace metrizamide in this respect.
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PMID:Intrathecal injection of Iohexol for routine myelography and CT myelography in 1,000 cases. 220 3

A 53-year-old male presented with an abdominal mass and urinary disturbance. Plain pelvic X-rays revealed a scimitar deformity of the sacrum. Computed tomography (CT) of the abdomen and lumbosacral spine showed a 13 X 17 X 17 cm, hypodense, cystic mass. Metrizamide myelography disclosed a bony defect at the S2 level through which contrast material entered the pelvic cyst, confirming the diagnosis of anterior sacral meningocele. Magnetic resonance imaging demonstrated the extent of the abdominal mass and its communication with the thecal sac through the anterior sacral defect. The patient underwent surgery via the transabdominal approach. The mass was extremely adherent to the intestine and it was difficult to reach the stalk of the sac. The wall of the meningocele was resected to the extent possible, and was tightly sutured following a meningocele-peritoneal shunting procedure. Postoperatively, the patient was neurologically normal, but 4 months later he was readmitted because of headaches and clouding consciousness. CT showed bilateral chronic subdural hematomas. Following their evacuation, the patient recovered uneventfully. The clinical and neuroradiological features and the surgical approaches to anterior sacral meningoceles are discussed.
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PMID:[Anterior sacral meningocele. Case report]. 247 71

A retrospective study of 50 patients was undertaken to observe the postoperative side effects experienced by patients undergoing metrizamide (Amipaque) myelography followed by laminectomy on the same day and to compare them with side effects experienced if the laminectomy was postponed at least one day. Results documented that the incidence of nausea was statistically greater in Group 1 (myelogram and surgery the same day) than in Group 2 (delayed surgery). While the occurrence of vomiting and headache in Group 1 was also greater, the numbers did not reach statistical significance. Group 1 did require significantly more doses of antiemetics for a longer period of time. The groups did not differ in the length of time an intravenous (IV) infusion was in place, but Group 1 patients required a significantly greater number of urinary catheterizations for retention and residual for longer than three days. The length of stay and the time from surgery to discharge was the same for both groups.
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PMID:Side effects following metrizamide myelography and lumbar laminectomy. 295 44

Metrizamide dorsal myelography was performed in two patients with minor to moderate sensorimotor paraparesis. Direct and indirect myelographic signs of spinal arteriovenous aneurysm were seen and spinal cord angiography showed thoracic dural arteriovenous fistulae (AVF) in both cases. Within 24 hours following myelography, clear neurological worsening occurred, associated with cephalalgia, nausea and transient diplopia in one case, leading to paraplegia in a few days. Paraplegia was complete six months after surgery in one case, and had resolved after embolization of fistula in the other patient. The mechanism of neurological worsening may include: substraction of cerebrospinal fluid, sitting position during and after myelography and local increase of metrizamide concentration secondary to impaired resorption caused by the fistula. Water-soluble myelography is of invaluable aid in the diagnosis of dural AVF and must be followed by early angiography, thus allowing prompt therapeutic embolization.
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PMID:[Spinal dural arteriovenous fistulae: exacerbation after myelography with metrizamide]. 342 Mar 55

A case of clival chordoma without bone destruction is reported. A 28-year-old man was admitted to Kagoshima University Hospital on April 8, 1983 with the complaints of headache, displopia and gait disturbance. Neurological examination revealed the right eighth, ninth, tenth nerve palsy and gait disturbance. Plain skull firms showed no abnormality and left vertebral arteriography revealed a displacement of basilar artery to the left side. The CT scanning showed a low density area at the retroclival region, and enhancement was acquired slightly. Metrizamide cisternography, CT cisternography showed retroclival round tumor and no destruction of the bone. The tumor which invaded intradurally was removed totally. Histological examination confilmed the chordoma. In this report, it will be stressed that when clival chordoma invades intradually, subtemporal approach will be most favorable, and metrizamide CT cisternography is one of the useful diagnostic procedures of retroclival mass.
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PMID:[A case of clival chordoma without bone destruction]. 371 80


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