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

Metrizamide, a major contrast agent for myelographic procedures, has rarely been reported to cause irreversible neurologic complications. The major transient neurologic alterations include neuropsychological reactions, generalized tonic-clonic seizures, and headaches. Two cases of irreversible spinal neurologic deficits resulting from metrizamide myelography are reported, and the factors that may increase the risks of complications in metrizamide myelographic studies are discussed, including preexisting dehydration, patient positioning, and the concentration of contrast agent.
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PMID:Irreversible neurologic complications of metrizamide myelography. 653 48

Spontaneous ventriculocisternostomy rarely occurs in obstructive hydrocephalus. The authors experienced a case of spontaneous ventriculocisternostomy diagnosed by CT scan with metrizamide and Conray. Patient was 23-year-old male who had been in good health until one month before admission, when he began to have headache and tinnitus. He noticed bilateral visual acuity was decreased about one week before admission and vomiting appeared two days before admission. He was admitted to our hospital because of bilateral papilledema and remarkable hydrocephalus diagnosed by CT scan. On admission, no abnormal neurological signs except for bilateral papilledema were noted. Immediately, right ventricular drainage was performed. Pressure of the ventricle was over 300 mmH2O and CSF was clear. PVG and PEG disclosed an another cavity behind the third ventricle, which was communicated with the third ventricle, and occlusion of aqueduct of Sylvius. Metrizamide CT scan and Conray CT scan showed a communication between this cavity and quadrigeminal and supracerebellar cisterns. On these neuroradiological findings, the diagnosis of obstructive hydrocephalus due to benign aqueduct stenosis accompanied with spontaneous ventriculocisternostomy was obtained. Spontaneous ventriculocisternostomy was noticed to produce arrest of hydrocephalus, but with our case, spontaneous regression of such symptoms did not appeared. In the literature, arrest of hydrocephalus was noted in 50 per cent of 14 cases of obstructive hydrocephalus with spontaneous ventriculocisternostomy. By surgical ventriculocisternostomy (method by Torkildsen, Dandy, or Scarff), arrest of hydrocephalus was seen in about 50 to 70 per cent, which was the same results as those of spontaneous ventriculocisternostomy. It is concluded that VP shunt or VA shunt is thought to be better treatment of obstructive hydrocephalus than the various kinds of surgical ventriculocisternostomy.
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PMID:[Case of spontaneous ventriculocisternostomy: with special reference to a CT finding]. 660 89

The patient, 64-year-old female, had episode of sudden attack of severe vertigo, headache, nausea, and vomiting which lasted for about twenty minutes on May 20th in 1980. She had hypertension, polyp of stomach, diverticuli of duodenum in her past history. Neurological examination on her admission revealed fine horizontal nystagmus on bilateral gaze and slight clumsy movement on left F-N test. On plain skull and cervical X-P, atlanto-occipital fusion and Klippel-Feil syndrome (C2-C3 fusion) were seen. Plain CT scanning revealed a large cystic lesion which extended from the vermis to the left cerebellar hemisphere. No enhanced area was seen. The forth ventricle was seemed to be enlarged. And the left-sided dorsal part of the forth ventricle attached to the cyst. Metrizamide CT cisternogram showed there was no direct communication between them. Angiographically, the vertebrobasilar arteries were noted sclerotic changes and poor vascularities in the left cerebellar hemisphere was noted. On opening the dura during surgery, the left cerebellar hemisphere appeared bulging state and the bilateral cerebellar tonsils were hypoplastic. Outer thin membrane of the cyst was removed. The cyst has no communication with the subarachnoid space as well as with the forth ventricle. The cystic fluid was slightly yellowish, but had no Froin's sign. Reddish-gray color nodular area, which seemed to be similar to mural nodule macroscopically, was noted in the area of inner surface of the cyst. This part was removed. Histological findings of this area showed abnormal architecture with malarranged layer of cerebellar cortex.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Cerebellar cyst associated with cytoarchitectonic abnormalities in the cerebellar cortex]. 662 88

A 14-year-old girl had headaches and sudden loss of vision as a result of total retinal detachment in association with the morning glory optic nerve anomaly. Metrizamide cisternography with contrast dye introduced into the subarachnoid space disclosed migration of metrizamide with radiographic enhancement in the subretinal space. The demonstration of an abnormal communication between the subarachnoid and subretinal spaces suggested that the subretinal fluid is of cranial origin. The patient underwent surgical removal of a window of dura from the optic nerve sheath. This resulted in retinal reattachment and improvement of visual acuity to 20/200. The retina was still attached after a 15-month follow-up period.
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PMID:Treatment of total retinal detachment in morning glory syndrome. 672 Aug 39

A case of pineal gangliocytoma in a 51 year-old man is presented. He was admitted to the hospital on February 2, 1982, with complaints of headache, nuchal pain, blurred vision, nausea and vomiting of three years' duration. Neurological examination did not show any neurological deficits but bilateral choked disc. Preoperative CT scan disclosed a sharp by circumscribed high density lesion in the pineal region with moderate hydrocephalus. Preoperative 99m Tc-DTPA brain scan revealed a warm activity in the pineal region, and changes of its activity were only little in the course of time. Preoperative Amipaque ventriculogram showed dilation of the lateral ventricles and a shadow of the tumor bulging into the posterior half of the distended third ventricle. A diagnosis of tumor of the pineal region was made and removal of the tumor was performed by biparieto-occipital interhemispheric approach in "sea lion" position. The tumor was a dark reddish solid mass which replaced the pineal body and extended under the cerebellar tentorium. The patient made an uneventful recovery without any neurological deficits. By light microscopy, the neoplasm was composed mostly of mature and immature ganglion cells and small round cells with moderate cellularity and multiform cytologic features. Ganglion cells with large nuclei and prominent nucleoli had characteristic Nissl substance in various amounts. Oligodendrocytes and astrocytes appeared around the tumor but did not show neoplastic growth. GFAP stain did not show glial component in the tumor. According these findings, the tumor was diagnosed as gangliocytoma originated from the pineal body, and this was the first case in Japan.
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PMID:[Gangliocytoma of the pineal body. A case report and general review]. 673 97

A clinical assessment of metrizamide (Amipaque) lumbar myelography in 150 patients is reported, and the adverse reactions encountered are presented and discussed. Minor adverse reactions--headache (48%), nausea (10%) and vomiting (7%)--were common, and the incidence reflected overseas experience. Severe headache occurred in a significant proportion of patients (20%), despite adequate hydration and the use of a small-gauge needle. There were no major adverse reactions such as epilepsy or severe muscle spasm. The study suggests that metrizamide is well tolerated, gives good anatomical demonstration and should replace iophendylate (Myodil) in this region. Recent reports of occasional, but sometimes severe, neurological complications indicate that further cautious assessment is required.
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PMID:Lumbar myelography today. Experience with metrizamide, a water-soluble, non-ionic contrast medium. 701 91

Thirty-four patients were submitted to the conventional cervical myelography by administration of metrizamide (Amipaque) through three routes (lumbar 23, suboccipital 6, C1-C2 lateral 5). After the injection of metrizamide (4-11 ml, 170-250 mgI/ml), all procedures of the cervical myelography were done as soon as possible within 9 minutes. The adverse reactions of Amipaque were observed in 29 cases (85%) out of 34 cases initially 1 hour after cervical myelography and disappeared completely in an average of 16 hours. The total number of the side effects was 140 incidences such as meningeal irritation (headache 18, nausea 17, vomiting 17), cerebellar signs (dizziness 11, dysarthria 8, tremor 5, bradylalia 2, dysmetria 2, tipsy feeling 2, dysdiadochokinesis 1), autonomic signs (flushing 7, pale face 4, fever 4, sweating 2, hiccup 2, fatigability 2, micturition disturbance 1), sensory signs (exacerbation of numbness 6, perioral numbness 3, back pain 1, chest pain 1), motor signs (focal muscle spasm 5, exacerbation of paresis 4, areflexia 1), psychiatric signs (dysphasia 3, disturbance of consciousness 2, euphoria 1, persecutory delusion 1) and muddiness 7. We observed that waxing and waning of side effects correlated tightly with transient cortical penetration of dye in CT and cortical dysfunction mainly slowing of the background activity and slow wave burst in EEG. According to high frequency of side effects in our study, we suggest that a greater incidence of side effects may result when high concentration of Amipaque comes in contact with the cerebral cortex by using an inadequate fluoroscopic table which has only fixed one plane image and rough positioning control. Slow absorption into blood stream may affect appearance and maintenance of side effects. In order to decrease side effects after Amipaque cervical myelography, we propose that we should introduce a mobile rotating chair coupled with high power image and chose C1-C2 lateral route using 1500-1700mgI of Amipaque.
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PMID:[Side effects of metrizamide (Amipaque) cervical myelography (author's transl)]. 711 May 15

In 320 cases contrast investigations of the vertebral column were carried out injecting by lumbar tap Metrizamide in 174 cases and Amipaque in 126 cases. In 259 cases the investigation was limited to the lumbar part, in 25 cases to the thoracic part, and in 19 cases to the cervical part of the spine. In 12 cases the whole vertebral canal was explored in this way. In 5 cases only epidurography was done. Very good or good contrast filling of the dural sac was obtained in the thoracolumbar segment using contrast medium 200 mg I/ml. In some cases this degree of concentration was inadequate for good visualization of the cervical segment. Side effects included headaches in 52%, nausea in 15%, vomiting in 4% of cases. In 28% of cases fever up to 38 degrees C was observed on the first day after the procedure. In 8 cases of repeated radiculography no evidence of arachnitis was demonstrated.
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PMID:[Radiodiagnosis of the spinal canal using a nonionic contrast medium]. 734 2


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