Obstructive hydrocephalus following Pantopaque myelography.

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.