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

Two cases of the primary empty sella complaining of intractable headache for many years are reported. Case 1. A 73-year-old female was admitted on August 23, 1983 because of intractable headache. Plain skull radiograph showed slightly enlarged sella with deepening of the floor. Metrizamide CT scan demonstrated the sella cavity filled with metrizamide extensively. Operation was done performing intrasellar intradural plugging via transsphenoidal route (Hardy's technique). Postoperatively headache was improved. Case 2. A 43-year-old female was admitted on July 24, 1984 after many years of intractable headache. Craniogram demonstrated deep sella of slightly increased volume and unaltered dorsum sellae. On metrizamide CT scan, contrast medium occupied greater parts of the sellar cavity. Extradural intrasellar plugging (Guiot's technique) was performed. Postoperative course was uneventful. Surgical procedure on the primary empty sella relieved headache by decreasing intrasellar pressure and alleviating pulsatile pressure on the dulla. Operation via transsphenoidal method was the suitable procedure because of less trauma on the optic nerve and advantageous plugging of the sellar cavity. Guiot's technique with extradural intrasellar plugging may be more preferable because of accompanying no postoperative cerebrospinal fluid rhinorrhea.
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PMID:[The surgical treatment of primary empty sella]. 372 80

Delineation of the thecal sac in CT can be improved by the presence of intrathecal metrizamide. This may be especially helpful in postoperative patients in whom the landmarks are often obscured by epidural scarring. Metrizamide-enhanced CT was performed on outpatients using 2 1/2 ml metrizamide (170 mg I/ml). Follow-up is available on 40 patients. The procedure was well tolerated with only three instances of severe headache, one case of vomiting, and no reported seizures. Adequate opacification was obtained at 92% of the levels examined with fair opacification at the remainder of the levels. This technique is considered a safe and useful outpatient procedure.
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PMID:Low-dose metrizamide spinal computed tomography in outpatients. 375 34

A case of a cavernous angioma of the cauda equina is presented. The patient was a 28-year-old man who experienced sudden low-back pain and headache without neurological symptoms. Lumbar puncture revealed subarachnoid hemorrhage. He had suffered a similar episode 3 years previously. Selective spinal angiography did not demonstrate any abnormal vascularity. Metrizamide myelography and magnetic resonance imaging were useful in demonstrating the presence of a tumor. Laminectomy at L1-3 and total removal of the tumor were performed without neurological deficit.
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PMID:Cavernous angioma of the cauda equina producing subarachnoid hemorrhage. Case report. 378 46

The side effects associated with the use of Metrizamide, Iopamidol and Iotrol in two double blind studies on lumbar myelography were determined. The cause of headache is explained on the one hand as the result of the distribution of the contrast substance in the CSF space (early headache) and on the other hand due to the CSF leak through the puncture lesion. Iotrol seems to be the safest contrast substance for intrathecal use, however it should be used in the smallest possible amount to reduce even further contrast-related effects in myelography.
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PMID:[Myelography and headache]. 389 52

The authors present the results of own investigations on the occurrence of side effects following myelography with the contrast medium Amipaque administered usually by the lumbar route. Sixty patients aged 21-65 years with various diseases of the spinal cord and cauda equina were studied. Clinical and myelographic investigations were performed before and after myelography. In 6 out of 60 cases (10%) transient neurological disturbances developed including epileptic seizures, speech disturbances of the type of aphasia and dysartria, visual disturbances and twitching of lower extremities. Other symptoms and signs included: headaches, vomiting, collapse. One patient with cardiorespiratory failure died hours after myelography with evidence of increased symptoms of cardiorespiratory failure. EEG changes appeared after myelography in 2/3 of cases and persisted for up to 12 days. The authors call attention to the high proportion of neurological complications and EEG changes which must be taken into account when indications to myelography are considered. Particular caution is necessary in cases with coexistent cardiorespiratory failure.
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PMID:[Clinical and electroencephalographic signs of side effects in patients after myelography using "amipaque"]. 404

The pharmacology, side effects, and possible drug interactions of metrizamide, a water-solulbe contrast medium for myelography, are reviewed. Metrizamide concentration in the brain reaches maximal levels two to six hour after lumbar injection, depending on dose and patient positioning, and is largely (55-96%) excreted from the body after 24 hours. Its lower neurotoxicity, compared with other water-soluble contrast agents, can be attributed in part to its undissociated, non-ionic nature. Common side effects, which include headache, nausea, and vomiting, occur to the same degree as with other myelographic contrast media. Reported data suggest that convulsions, which have occurred in a very small percentage of patients, are related to the amount of contrast medium reaching the brain which, in turn, is largely a factor of dose and examination technique. Although the risk of seizures is small, it is recommended that drugs that lower the seizure threshold (phenothiazine derivatives, butyrophenones, tricyclic antidepressants, and MAO-inhibitors) should be avoided 48 hours before metrizamide administration (if possible), should not be used to control nausea, and should not be resumed for 24 to 48 hours after the myelographic procedure. The value of premedication (e.g., with diazepam) to prevent seizures has not been established and is not recommended.
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PMID:Metrizamide: a review with emphasis on drug interactions. 610 72

A randomised blind trial comparing Iopamidol (Niopam) and Metrizamide (Amipaque) for lumbar radiculography was performed in 100 patients. Significantly more patients receiving Metrizamide complained of having severe headaches (P less than 0.05) and vomiting (P less than 0.05). There was no difference in quality of the radiculograms.
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PMID:A randomized blind trial of iopamidol (Niopam) and Metrizamide (Amipaque) in lumber radiculography. 633 15

In a prospective double-blind randomized study involving 40 patients undergoing lumbar myelography, an attempt was made to correlate adverse effects of the examination with contrast medium dosage. Metrizamide for myelography is dispensed in two dosage aliquots, 3.75 and 6.75 g. In one group of 20 patients (10 males and 10 females) the higher dose was utilized routinely, in a second similar group the lower dose. 24 h after myelography complaints of headache were noted in 9 out of 40 patients; nausea, sometimes with vomiting, in 3 out of 40, and giddiness or light-headedness in 6 out of 40. No other side effects were registered. Complaints after myelography occurred significantly more often in females than in males, but there was no correlation between the incidence of complaints and the dose of metrizamide administered.
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PMID:Relationship between contrast medium dose and adverse effects in lumbar myelography. 638 Aug 85

A randomized double blind study with iohexol (Omnipaque) and metrizamide (Amipaque) in cervical myelography was performed in 50 patients, 29 with iohexol and 21 with metrizamide. The myelographies were performed either with lumbar or with C1-C2 puncture in about equal groups, using 300 mg I/ml and 240 mg I/ml of the contrast media respectively. The image quality was equal with both contrast media, excellent in about 4/5 and good in 1/5 of the examinations. Subjective side effects were twice as frequent with metrizamide as with iohexol. The most frequent side effect was headache, occurring in 34% with iohexol and in 67% with metrizamide. Altogether 24% or the patients had EEG changes after iohexol as compared to 47% after metrizamide. All EEG changes were slight dysrythmia-except in three patients with spike activity after metrizamide. These were the only ones with mental reactions as well. It can be concluded that in this trial iohexol was better suited for cervical myelography than metrizamide.
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PMID:Iohexol compared to metrizamide in cervical and thoracic myelography. A randomized double blind parallel study. 639 Feb 48

Two nonionic contrast media, iopamidol and metrizamide (Amipaque), were used for cervical myelography (C1-C2 puncture) in 95 consecutive patients. Both contrast media gave excellent radiographic results. Headache and vagal symptoms were similar in both groups, whereas metrizamide produced more electroencephalographic changes and epileptic seizures. Meningeal irritation occurred in both groups and was severe in three cases. Cerebrospinal fluid showed protein and cellular changes of inflammatory type in both groups. Iopamidol is considered to be the more suitable contrast medium for cervical myelography despite its slight neurotoxicity.
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PMID:Iopamidol and metrizamide in cervical myelography: side effects, EEG, and CSF changes. 641 Aug 70


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