Serious or fatal complications after inadvertent administration of ionic water-soluble contrast media in myelography

Eur J Radiol. 1992 Sep;15(2):95-100. doi: 10.1016/0720-048x(92)90131-r.

Abstract

The consequences of the inadvertent administration, by the intrathecal route, of ionic contrast media instead of iopamidol in seven subjects are reported. The ionic compounds were diatrizoate, iodamide and ioxitalamate. The outcome was fatal in three out of seven subjects, and it depended on the type and the dose of the administered contrast agent. The serious or fatal reactions observed are a tragic confirmation of the predictive power of neurotoxicity data obtained in animal studies with various iodinated water-soluble compounds. The margin of safety, represented by the ratio of LD50 i.ce. in mice to clinical dose in humans, both normalized to bodyweight, appears to reliably reflect the risk of toxic reactions after intrathecal administration of iodinated contrast agents.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Contrast Media / adverse effects*
  • Diatrizoate / adverse effects
  • Female
  • Humans
  • Injections, Spinal
  • Iodamide / adverse effects
  • Iothalamic Acid / adverse effects
  • Iothalamic Acid / analogs & derivatives
  • Male
  • Medication Errors*
  • Middle Aged
  • Myelography*

Substances

  • Contrast Media
  • Diatrizoate
  • Iothalamic Acid
  • Iodamide
  • ioxitalamic acid