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Obstructive hydrocephalus following Pantopaque myelography
Abstract:
A case with delayed development of obstructive hydrocephalus most probably caused by Pantopaque myelography is reported. At autopsy it was found that the foramina of Magendi and Luschka were occluded by granulation tissue in which the most common findings were multinucleated giant cells containing calcareous and unstained vacuoles, frequently surrounding empty hollows, many lymphocytes and plasma cells. As compared with two other similar cases and several animal investigations this shows that the reaction of the tissue is typical of a Pantopaque reaction.
Insights
Delayed obstructive hydrocephalus, likely from Pantopaque myelography, was observed. Autopsy revealed granulation tissue occluding foramina, characteristic of a Pantopaque reaction.
Area of Science:
- Neurology
- Pathology
Background:
- Pantopaque myelography, a diagnostic imaging technique, has been associated with potential complications.
- Obstructive hydrocephalus is a condition characterized by the buildup of cerebrospinal fluid in the brain.
Observation:
- A case of delayed obstructive hydrocephalus is presented, suspected to be caused by Pantopaque myelography.
- Autopsy findings revealed occlusion of the foramina of Magendie and Luschka by granulation tissue.
Findings:
- The granulation tissue contained multinucleated giant cells with calcareous deposits and unstained vacuoles, often surrounding empty spaces.
- Significant infiltration of lymphocytes and plasma cells was noted within the granulation tissue.
- These histological findings are consistent with a typical Pantopaque reaction, supported by comparison with similar cases and animal studies.
Implications:
- This case highlights a rare but serious delayed complication of Pantopaque myelography.
- Understanding the tissue reaction is crucial for diagnosing and managing post-myelography complications.
- The findings emphasize the importance of considering Pantopaque-induced inflammation in cases of unexplained hydrocephalus after myelography.