Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Feb 1978
Case ReportsIntraspinal arachnoiditis and hydrocephalus after lumbar myelography using methylglucamine iocarmate.
A 35 year old woman developed a severe meningeal reaction after lumbar myelography using the water-soluble contrast medium methylglucamine iocarmate. Three months after myelography the findings were a transverse spinal cord syndrome corresponding to the middle thoracic segments resulting from well developed leptomeningeal adhesions. ⋯ After treatment with a ventriculoatrial shunt the patient is almost free of symptoms. A possible pathogenetic relationship between the contrast medium, the chronic leptomeningeal changes, and the symptoms of our patient is discussed on the basis of the literature.
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Spinal arachnoiditis is a rare condition. Eighty cases, diagnosed during a period when 7600 spinal contrast investigations were undertaken, have been reviewed. ⋯ This accounts for the persistence of radicular symptoms and the relatively low incidence of paraplegia when compared with earlier series. Surgery does not appear to have any role in the treatment.