Inadvertent intrathecal use of ionic contrast agents: Treatment with immediate ventriculolumbar lavage

Inadvertent intrathecal use of ionic contrast agent

“…All patients (n=6) who were treated with active removal of the CM by intrathecal drainage/lavage survived, as in our case [7,10,11,12,22]. Different modes of intrathecal lavage have been described.…”

“…In most cases accidental injection occurred during myelography (23 cases) [2,5,7,10,16,17,18,19], but it may also occur during other "non-CNS" procedures with accidental piercing of the dura mater, such as epidurography (4 cases) [11,13] and discography (1 case) [18]. Passage of ionic CM through a fistulous connection with the subarachnoid space occurred during sinography of a pelvic abscess [9], and during opacification of a fistula which developed at the operation site postoperatively after implantation of S88 Harrington bars [12]. Another case of unusual entry was caused by trauma during percutaneous nephrography [20].…”

Inadvertent Intrathecal Administration of Ionic Contrast Medium to a Dog

“…Most authors placed the patient in an upright position to limit migration of the contrast medium to the brain, as in humans myelography occurs with lumbar injection. 10,13,15,16,[19][20][21] Immediate removal of the contrast medium has been reported to be the treatment of choice. 13,22 In some patients, lumbar puncture was performed, sometimes successfully, 13,16,20,23 but other patients eventually died.…”

“…lower catheter. 10,16,19,21,25,26 Some patients in whom lumbar puncture and intrathecal lavage were not performed recovered, 15,17 but in those patients the amount of contrast medium injected was small. All patients with intrathecal lavage survived.…”

“…All patients with intrathecal lavage survived. 10,16,19,25 Intrathecal lavage seems to be the treatment of choice for such accidents. In our dog, the CSF was drained but not lavaged.…”