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[The problem of postmyelography headaches]

E Avrahami, D F Cohn

    Schweizer Archiv Fur Neurologie, Neurochirurgie Und Psychiatrie = Archives Suisses De Neurologie, Neurochirurgie Et De Psychiatrie
    |January 1, 1982
    PubMed
    Summary

    Myelography contrast material can cause severe headaches. Limiting contrast material penetration into the skull, particularly into the hypophyseal region, may reduce the incidence of prolonged headaches following the procedure.

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    Area of Science:

    • Neurology
    • Radiology
    • Medical Imaging

    Background:

    • Myelography is an imaging procedure that uses contrast dye to visualize the spinal cord and surrounding structures.
    • Headaches are a common complication following myelography, with varying onset and duration.

    Purpose of the Study:

    • To investigate the relationship between contrast material spread during myelography and the occurrence of headaches.
    • To identify factors contributing to prolonged post-myelography headaches.

    Main Methods:

    • Observation of 68 patients before and after myelography.
    • Correlation of contrast material location (e.g., great cistern, sella turcica) with reported headache onset.
    • Assessment of contrast material remnants in the hypophyseal region in patients with prolonged headaches.

    Main Results:

    • 35 patients reported headaches upon contrast material entry into the great cistern.
    • 22 patients experienced immediate headaches when contrast reached the sella turcica region.
    • 12 patients with persistent headaches showed contrast remnants in the hypophyseal region, suggesting potential vascular irritation.

    Conclusions:

    • Contrast material penetration into the cranial cavity, especially the hypophyseal region, is linked to post-myelography headaches.
    • Irritation of major cerebral blood vessels may cause these headaches.
    • Performing lateral X-rays while patients are in a lateral decubitus position may minimize contrast material spread into the skull.

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