Two female patients are described with acute bilateral central scotomata with preservation of central vision following spinal anesthesia. Both patients had a temporary drop in systemic blood pressure and underwent caesarean section with moderate blood loss. In order to explain the visual field defects extensive ophthalmological examination and CT-scanning with nuclear magnetic resonance imaging were performed. The hypothetical explanation for the visual field defects is transient macular ischemia.

This report concerns a clinical trial with gadolinium-DTPA (Gd-DTPA) as an intravenous contrast medium for magnetic resonance imaging (MRI) in patients with disorders of the central nervous system. Fifty patients, 30 females and 20 males, were examined without and with Gd-DTPA. The contrast medium was well tolerated by all patients. The results of MRI scanning without and with Gd-DTPA and those obtained with computed tomography (CT) using intravenous contrast enhancement were compared. This investigation comprised mainly patients with intracranial tumors, multiple sclerosis, and nasopharyngeal tumors. The results may be summarized as follows: I) MRI with Gd-DTPA (MRI +) gave better results than MRI without Gd as regards delineation of the lesion, blood vessels and edema in cerebral tumors, pituitary adenomas and acute forms of multiple sclerosis (MS). 2) MRI+ was better than CT in 32 of the 50 cases examined; with intracerebral tumors it was better in 15 out of 18 cases. 3) MRI + was always better than CT in patients with MS. In 3 out of 7 cases MRI demonstrated the acute MS lesions. 4) MRI + seemed to have advantages also in nasopharyngeal tumors as ascertained from this limited experience.

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This report concerns a clinical trial with Gd-DTPA as an intravenous contrast medium for MRI in patients with neurological disorders. 50 patients (30 female, 20 male) were examined without and with Gd-DTPA and the results of CT scanning and MR scanning without and with Gd-DTPA were compared. All patients tolerated the contrast medium very well. In the various patient groups, Gd-DTPA often added to the information. This was especially true in the tumor group, where better delineation of tumor, blood, and edema was obtained.

Iohexol 300 mg I/ml and Hexabrix 320 mg I/ml have been compared in a randomized, double blind, parallel study, to evaluate hemodynamic parameters, diagnostic information and adverse reactions. A total of 55 patients entered the study, one of them was later excluded, because both contrast media were given by mistake. In the included material, 21 patients were given iohexol 300 mg I/ml in 55 selective injections, and 23 patients Hexabrix 320 mg I/ml in 65 selective injections. The median total dose was 52 (12-88) ml in the iohexol group and 51 (13-118) ml in the Hexabrix group. No changes in heart rate were seen. Angiograms of good or excellent quality were obtained, and no difference between the two media was shown. No serious adverse reaction occurred, and no statistical significant difference was found between the two media with respect to subjective patient reactions. The results indicate that the non-ionic, low-osmotic contrast medium iohexol is well tolerated in cerebral angiography with respect to the parameters tested. No statistical significant difference was found in any of these parameters between iohexol and Hexabrix.