A literature search found no clinical trials or guidelines addressing the management of spontaneous intracranial hypotension (SIH). Based on the available literature and expert opinion, we have developed recommendations for the diagnosis and management of SIH. For typical cases, we recommend brain magnetic resonance (MR) imaging with gadolinium to confirm the diagnosis, and conservative measure...

Forty-three patients underwent lumbar myelography with the new, nonionic contrast medium iohexol. Multiple laboratory examinations, neurologic examinations, and electrocardiograms showed no significant alterations af1er intrathecal injection of the contrast agent. Mild electroencephalographic changes were seen in one patient. Nineteen adverse reactions occurred in 13 patients; only one of them ...

Metrizamide is largely replacing iophendylate (Pantopaque) for routine lumbar myelography. Better visualization of the nerve root sheaths should make metrizamide myelography more sensitive in detecting laterally herniated disks, such that epidural venography might be required less often. However, that expectation has not been realized. In over 800 consecutive myelograms, one-half obtained with ...

BACKGROUND Myelography is routinely performed safely using nonionic water-soluble radiographic contrast media. However, inadvertent introduction of ionic contrast media into the thecal space can result in a syndrome of spasms and convulsions, which can lead to death if not recognized and dealt with in a timely manner. METHODS We report a case of inadvertent use of the ionic diatrizoate meglum...

BACKGROUND AND PURPOSE Powerful tools, including CT and MR imaging, have revolutionized neuroimaging. These are routinely used, but the extent and variation of use has not been studied. Our purposes were to determine the use rates of MR imaging and CT (of spine, brain, or head and neck), myelography, conventional angiography, and MR angiography in diagnosing neurologic disorders; to study trend...

A 53-year-old woman with superficial siderosis underwent spinal MR imaging, which demonstrated a large cervicothoracic epidural fluid collection compatible with a CSF leak. Conventional and dynamic CT myelography failed to localize the dural tear because of rapid equilibration of myelographic contrast between the thecal sac and the extradural collection. The superior temporal resolution of digi...

This case demonstrates the myelographic, CT myelographic, and MR appearance of primary lymphoma of the cauda equina. It also illustrates the utility of high-resolution CT myelography in certain lesions of the cauda equina. The authors feel that CT myelography, with its inherent ability to depict individual nerve roots and therefore any pathologic involvement as well, should be considered an adj...