Meglumin-Iodrinat has been synthesized as the contrasting part of Myelografin by Schering AG. and tested for lumbar Myelography in animal experiments. The excellent neural and general compatibility justified a first clinical trial. 200 patients were examined, 100 each with following upright or lying down positions. There were no local symptoms, no signs of spinal or cerebral irritation. This is seen to be the main advantage compared with drugs used so far. Intensity of contrast corresponded with that of Conray 60 and Dimer X. The most common complaints like headache and nausea were interpreted as CSF hypotension and can be clearly reduced by lying down. Also the concentration of the contrastmedium diminishes more rapidly with the patient lying down.
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Cureus
November 2024
Department of Internal Medicine, Aga Khan University Hospital, Nairobi, KEN.
Post-dural puncture headaches usually occur when the cerebrospinal fluid (CSF) leaks due to trauma to the dura mater. This often results in spontaneous intracranial hypotension characterized by orthostatic headaches, neck stiffness, and nausea. In this case report, we discuss a 20-year-old male patient who developed symptoms of intracranial hypotension one year following a lumbar puncture.
View Article and Find Full Text PDFJ Neurosurg Spine
December 2024
Departments of1Neurosurgery.
Objective: Hounsfield units (HUs) may better predict biomechanical complications of instrumented fusion than conventional bone quality measures. Typically, noncontrast axial slices are used. This study aims to address the influence of reconstruction plane and contrast administration on measured HUs in patients undergoing lumbar spine imaging.
View Article and Find Full Text PDFNeuroimaging Clin N Am
February 2025
Department of Radiology, Division of Neuroimaging and Neurointervention, Stanford University Medical Center, Center for Academic Medicine, Stanford University Center for Academic Medicine; Radiology + MC: 5659, 453 Quarry Road, Palo Alto, CA 94304, USA. Electronic address: https://twitter.com/BryanLanzman.
Despite all the advantages of magnetic resonance (MR) imaging, there still exist contraindications or limitations to its use. Thus, MR imaging has not entirely replaced fluoroscopic or computed tomographic (CT) myelography to depict the outline of the spinal cord and its nerve roots after intrathecal injection of contrast medium. The growing recent interest of neuroradiologists to accurately diagnose and treat cerebrospinal fluid leaks has also driven a resurgent need for familiarity with this image-guided procedure.
View Article and Find Full Text PDFNeuroimaging Clin N Am
February 2025
Department of Radiology, Division of Neuroimaging and Neurointervention, Stanford University Medical Center, Center for Academic Medicine, Radiology + MC: 5659, 453 Quarry Road, Palo Alto, CA 94304, USA. Electronic address: https://twitter.com/BryanLanzman.
Patients requiring lumbar punctures (LPs) are frequently challenging or may be impossible to do through a standard lower lumbar route. Therefore, if clinically indicated, consideration of alternative anatomic access routes to the spinal subarachnoid space may be necessary. However, some of these approaches are unpopular or seldom used, may be challenging to perform, or are associated with potential significant complications especially when combined with limited operator experience.
View Article and Find Full Text PDFNeuroimaging Clin N Am
February 2025
Paediatric Interventional Neuroradiology, Department of Diagnostic & Interventional Radiology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada; Department of Medical Imaging, University of Toronto, 263 McCaul Street, 4th Floor, Toronto, Ontario M5T 1W7, Canada. Electronic address:
Image guidance is becoming standard of practice for cerebrospinal fluid sampling in children to improve success rates and avoid complications. This article discusses various imaging guidance techniques available in the pediatric age group. For neonates and infants, imaging guidance using ultrasound is the technique of choice, and for older children, fluoroscopy or even cone beam computed tomography can be used when anatomy is complex.
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