Intrathecal iodinated contrast-induced transient spinal shock.
Abhi Chand LohanaSejal NeelVishal DeepakMark SchauerPublished in: BMJ case reports (2020)
Transient spinal shock is a previously unreported complication of intrathecal contrast. A 63-year-old man presented with the chief complaint of worsening back pain. Computed topography of lumbar spine without contrast showed a lytic lesion. After international normalized ratio (INR) correction, patient was sent for CT myelogram. After intrathecal contrast injection, the patient dropped his blood pressure profoundly and developed clinical manifestations of spinal shock. Emergent intravenous bolus fluids were initiated resulting in improvement in blood pressure. Patient's spinal shock resolved within hours. CT myelogram was normal except previously known lytic lesion. It was concluded that the transient shock was most likely due to contrast injection. We believe that this is the first reported case of transient spinal shock following CT myelogram using water-soluble iodinated non-ionic contrast agent administered intrathecally.
Keyphrases
- contrast enhanced
- magnetic resonance
- spinal cord
- blood pressure
- computed tomography
- magnetic resonance imaging
- case report
- cerebral ischemia
- water soluble
- image quality
- diffusion weighted imaging
- type diabetes
- positron emission tomography
- spinal cord injury
- skeletal muscle
- oxidative stress
- ultrasound guided
- blood brain barrier
- low dose
- adipose tissue
- brain injury
- pet ct