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Effect of blood on arachnoiditis from aqueous myelographic contrast media
Abstract:
Bloody cerebrospinal fluid is thought to increase the risk of arachnoiditis from myelography with iophendylate, but not with aqueous media. An experimental study was undertaken of the effects of metrizamide, iocarmate, and blood, independently and in mixtures, on the production of arachnoid fibrosis. Monkeys exposed to a mixture of iocarmate or metrizamide and blood developed no more significant arachnoid fibrosis than animals exposed to the contrast medium alone. Lumbar puncture with bloody cerebrospinal fluid, although a possible cause of adverse effects, is not a contraindication to proceeding with metrizamide myelography.
Insights
Bloody cerebrospinal fluid does not increase arachnoid fibrosis risk during metrizamide myelography. This finding suggests that bloody spinal fluid is not a contraindication for this diagnostic imaging procedure.
Area of Science:
- Neurology
- Radiology
- Pathology
Background:
- Arachnoiditis risk after myelography is a concern.
- Previous contrast media (iophendylate) and bloody cerebrospinal fluid (CSF) were linked to arachnoiditis.
- Aqueous contrast media, like metrizamide, were thought to be safer.
Purpose of the Study:
- To investigate the effect of bloody CSF on arachnoid fibrosis following myelography.
- To compare the risks of metrizamide and iocarmate with and without blood in CSF.
Main Methods:
- An experimental study was conducted using monkeys.
- Animals were exposed to metrizamide, iocarmate, and blood, individually and in mixtures.
- Arachnoid fibrosis was assessed to determine the effects.
Main Results:
- Monkeys exposed to mixtures of iocarmate or metrizamide and blood showed no significant increase in arachnoid fibrosis compared to those exposed to contrast medium alone.
- The presence of blood in CSF did not exacerbate fibrosis when using these aqueous contrast agents.
Conclusions:
- Bloody CSF is not a contraindication for metrizamide myelography.
- Aqueous contrast media like metrizamide appear safe even in the presence of blood in the cerebrospinal fluid.