The authors describe the case of a man who presented with T2-T3 disc herniation. The lesion was successfully identified by computed tomography with iopamidol myelogram and other radiological examinations. A posterolateral approach was tried and made successful result by the aids of microsurgical divices.
Iopamidol

Niopam is a newer, nonionic, watersoluble contrast medium used predominately in cisternographic and myelographic studies with metrizamide lately. The former has fewer, less severe and shorter adverse reactions than the latter. Until now there were no reports on meningitis complicating Niopam CT cisternography or myelography. Now we present a case of aseptic purulent meningitis complicating Niopam CT cisternography.
Iopamidol* ; Meningitis* ; Metrizamide ; Myelography

Thoracic disc herniation is uncommon and only represents 0.25% to 0.75% of all symptomatic disc lesions. The difficulty in diagnosis has been the one of the major problems in the treatment of thoracic disc herniation. But at now, the use of computed tomography with or without water soluble contrast media makes the diagnosis more acurate. Recently, we diagnosed a case of T4, T5 disc herniation by computed tomography with iopamidol. Operation by transthoracic, transpleural approach was done with microsurgical technique, and the result was good. The case is reviewed and other surgical techniques on the literature is discussed.
Contrast Media ; Diagnosis ; Iopamidol

In a comparative, prospective randomized study 200 patients underwent myelography using iopamidol (150 patients) or metrizamide (50 patients) as contrast medium. Adverse reactions were few, mild, and short in duration in iopamidol myelography compared to metrizamide myelography. Seizure occured in 2 patients with the use of metrizamide. Iopamidol appears to be superior to metrizamide for intrathecal administration.
Humans ; Iopamidol* ; Metrizamide ; Myelography* ; Prospective Studies ; Seizures

PURPOSE: To determine the degree and effect of contrast enhancement of the hepatic parenchyma according to different injection rates, amounts and types of contrast materials. MATERIALS AND METHODS: A total of 270 patients were divided into nine groups. Each group received different volumes(120, 130, or 140ml) and was scannedwith different injection rates of 2, 3 or 4 ml/sec. Three kinds of contrast materials(Ultravist 370, Iopamiro 370, Optiray 320) were used. Hepatic enhancement was measured by comparing quantitative regions of interest(ROI) beforeand after bolus injection of contrast material which were evaluated on arterial, portal and delayed phase duringdouble spiral scanning. RESULTS: There was no significant statistical difference in contrast enhancement between the three kinds of contrast materials. In noncirrhotic patients, hepatic enhancement was greatest on portal phase and was greater at a rate of 4ml/sec than 2ml/sec or 3ml/sec on arterial phase. At the same injection rate, thevolume of contrast material was an important factor on portal and delayed phase. In the cirrhotic patients, Child's C showed more delayed peak enhancement than did Child's A. CONCLUSION: The important factors in contrast enhancement were injection rate on arterial phase and volume on portal and delayed phase. The optimal choice mustbe made after considering intrinsic variables ; in addition, our results are helpful for determining enhancement protocol during double spiral CT scanning.
Contrast Media ; Humans ; Iopamidol ; Liver* ; Tomography, Spiral Computed*

We report a case of the suprasellar arachnoid cyst with hydrocephalus which was incidental finding after minor head injury. Preoperatively, we studied the CT cisternography through lumbar route with niopam. It revealed that the arachnoid cyst was communicated with ventricles and delayed filling and clearance pattern of the cyst. The suprasellar arachnoid cyst with hydrocephalus was treated by combined craniotomy with partial removal of the membrane wall and cystoperioneal shunt. We reviewed the literature and discussed the diagnosis and treatment of the suprasellar arachnoid cyst.
Arachnoid* ; Craniocerebral Trauma ; Craniotomy ; Diagnosis ; Hydrocephalus ; Incidental Findings ; Iopamidol ; Membranes

27 Myelographies with Iopamidol and 27 myelographies with metrizamide were performed in order to compare adverse reactions, radiographic quality and effects on vital signs of the two contrast media after injection into the spinal subarachnoid space. Headache and nausea were less severe using Iopamidol. The most striking difference was found in adverse neurobehavioral reactions and associated electroencephalographic abnormalities which were noted in 7.4% of the metrizamide group but were not seen with the use of Iopamidol. Iopamidol was more stable than metrizamide in CSF. Image quality and diagnostic accuracy of Iopamidol myelography was equivalent to metrizamide for intrathecal application.
Contrast Media ; Headache ; Iopamidol* ; Metrizamide ; Myelography* ; Nausea ; Strikes, Employee ; Subarachnoid Space ; Vital Signs

The spontaneous spinal epidural hematoma has a rare occurrence. Recently the authors have experienced a case of chronic spontaneous thoracic epidural hematoma in a 26 year old woman. She presented with Lt. scapular and upper thoracic pain, paraparesis and acute voiding difficulty during pregnancy and postpartum period. The thoracic myelography with niopam was performed by lumbar tap and C1-2 tap. Resoluted spinal epidural hematoma was removed with nearly complete recovery after 5 weeks. There was no trauma history but Lt. scapular and upper thoracic pain had been developed during previous pregnancy about 3 years ago. We present that this case may be related with pregnancy and delivery.
Adult ; Female ; Hematoma ; Hematoma, Epidural, Spinal* ; Humans ; Iopamidol ; Myelography ; Paraparesis ; Postpartum Period ; Pregnancy

BACKGROUND: Although cervical epidural block can be a useful therapeutic treatment for head, neck and upper extremities pain, there is no consensus regarding the volume of injection required for pain management. Herein, the spreading in the vertebral segments after a cervical epidural injection of either a 5 or 10 ml volume was studied. METHODS: A total of 78 patients, suffering from head, neck and upper extremity pain, were selected. Cervical epidural blocks were performed consecutively with 5 ml (n = 42) and 10 ml (n = 36) of 0.4% mepivacaine and 222 mg I/ml iopamidol at the C7 T1 levels. Both anteroposterior (AP) and lateral radiographs were obtained under fluoroscopy, and the upper and lower epidural spreading of the contrast media in relation to the vertebral level was evaluated. RESULTS: The cervical epidural blocks were performed without complications. The rostral spreading of the contrast media in the vertebral segments in groups 1 and 2 were 5.6 +/- 1.1 and 6.1 +/- 1.1, respectively. The caudal spreading of the contrast media in the vertebral segments in groups 1 and 2 were 5.4 +/- 3.4 and 7.2 +/- 3.9, respectively. The total numbers of segments with vertebral spreading of the contrast media in both directions showed significant differences between the two groups. The numbers of patients who showed spreading of the contrast media up to C2 vertebral segment showed no significant differences between the two groups. CONCLUSIONS: 5 and 10 ml epidural injection volumes may be adequate for the spread of contrast media to the entire cervical spine. A 5 ml epidural injection volume, compared to a 10 ml volume, may be ample when considering the possibility of unnecessary caudal spreading of drugs and volume related complications in the management of head, neck and upper extremity pain.
Consensus ; Contrast Media ; Fluoroscopy ; Head ; Humans ; Injections, Epidural* ; Iopamidol ; Mepivacaine ; Neck ; Pain Management ; Spine ; Upper Extremity

Non-cardiogenic pulmonary edema (NCPE) is a rare adverse reaction to iodinated radiocontrast media (RCM), in which all previous cases were immediate reactions. A 56-year-old male was given iopamidol, a non-ionic, low osmolar RCM, during coronary artery angiography. He developed pulmonary edema and fever a day after the procedure. Despite diuretic therapy, the patient's pulmonary edema worsened and his high fever persisted. The patient's pulmonary edema was eventually resolved with intravenous steroid treatment. We interpreted the patient's condition as NCPE manifesting as a delayed reaction to RCM. To our knowledge, our case is the first to show NCPE as a delayed hypersensitivity reaction.
Angiography ; Contrast Media ; Coronary Angiography ; Coronary Vessels ; Fever ; Humans ; Hypersensitivity ; Hypersensitivity, Delayed ; Iopamidol ; Male ; Pulmonary Edema