Spinal Syrinx Due to Lipiodol-Induced Arachnoiditis
Jan Paquet1, Fleur Cordier2, Jelle Vandersteene1
1Department of Neurosurgery, Ghent University Hospital, Belgium.
World Neurosurgery
|February 18, 2021
Summary
A rare spinal cyst developed decades after Lipiodol injection, a contrast agent previously used for spinal imaging. This case highlights Lipiodol
Area of Science:
- Neurology
- Radiology
- Neurosurgery
Background:
- Lipiodol (ethiodized oil) was historically used for intrathecal injection in spinal imaging.
- Its use was discontinued due to adverse effects, including arachnoiditis and neurological complications.
Observation:
- A patient presented with a progressive symptomatic intramedullary cyst diagnosed decades after a Lipiodol injection.
- Surgical exploration revealed a membrane with Lipiodol deposits, suggesting a delayed reaction.
Findings:
- The intramedullary cyst (syrinx) is hypothesized to be secondary to cerebrospinal fluid pulsations acting on a reactive membrane.
- This membrane is believed to have formed due to Lipiodol-induced arachnoiditis.
Implications:
- This case underscores the potential for delayed neurological sequelae from Lipiodol, even many years after administration.
- It emphasizes the importance of considering historical Lipiodol exposure in the differential diagnosis of spinal cysts and arachnoiditis.
