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Cortical Blindness After Metrizamide MyelographyReport of a Case and Proposed Pathophysiologic Mechanism
James G. Smirniotopoulos, MD;
Frances M. Murphy, MD;
Dieter Schellinger, MD;
John F. Kurtzke, MD;
Frederick T. Borts, MD
Arch Neurol. 1984;41(2):224-226.
Abstract
• Metrizamide, a nonionic, water-soluble contrast medium, has been increasingly used for myelography. We saw a patient with cortical blindness, seizure, organic psychosis, and asterixis after undergoing attempted metrizamide myelography via C1-2 puncture. Computed tomography demonstrated early penetrance of metrizamide into the brain parenchyma, most prominently in the occipital lobes. A mechanism of direct metrizamide neurotoxicity was proposed.
Author Affiliations
From the Departments of Radiology (Drs Smirniotopoulos, Schellinger, and Borts) and Neurology (Drs Murphy and Kurtzke), Georgetown University Hospital, and the Department of Neurology, Veterans Administration Hospital (Dr Kurtzke), Washington, DC.
Footnotes
Accepted for publication March 3, 1983.
Reprint requests to Neuroradiology Section, Division of Radiologic Pathology, Armed Forces Institute of Pathology, Washington, DC 20306 (Dr Smirniotopoulos).
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