Recurrent hearing loss after myelography treated with epidural blood patch

Transient hearing impairment is a known sequel after various procedures that result in loss of cerebrospinal fluid, such as lumbar puncture, spinal anesthesia and myelography. But persistent or recurrent hearing loss after dural puncture is a rare entity. We present a case with recurrent low-frequency sensorineural hearing loss after myelography. The patient was treated successfully by means of an epidural blood patch, although the conservative treatment was ineffective.     

Myelography for severe thoracolumbar injuries

Summary Myelography was carried out on 30 patients with severe thoracolumbar injuries. In ten cases the myelography gave specific information which could not have been obtained by any other method. Myelography made within 1 month of trauma gave specific information in only one of 16 cases. Late myelography, in nine of 14 cases, provided valuable specific information about the type of cord atrophy, dorsal scar formation and transsection of the cord.     

Amipaque myelography without late adhesive arachnoid changes

Summary Sixty-three myelographies were performed with Amipaque. Remyelography after an interval of longer than 2 months showed that in one case there was progression of an arachnoiditis which had already been present during the first Amipaque study. In one other case there were minimal, unilateral nerve root changes caused by an intervening operation. Altogether 269 remyelographies without secondary late reactions are registered. Two cases of increased arachnoid changes from a previous myelography with another contrast medium hardly can be due to Amipaque.     

The contracting cord sign of multiple sclerosis

Summary A new sign of multiple sclerosis, the contracting cord sign, is described. The myelographic demonstration of a large cord that subsequently decreases in size may suggest multiple sclerosis. Multiple sclerosis must be considered in the differential diagnosis of an enlarged spinal cord. Distinguishing between the collapsing cord and the contracting cord is discussed.     

Solitary spinal metastasi from Wilms' tumor

A 7 year old boy presented with sudden lower extremity paresis six months after resection of a Wilms' tumor. Roentgenologic studies showed destruction of the sixth vertebral body and a thoracic extradural block by an epidural mass subsequently proven to be a solitary Wilms' metastasis.     

Iopamidol,a new non-ionic hydrosoluble contrast medium for neuroradiology

Summary The side effects associated with the use of Iopamidol for myelography were determined in 100 patients and compared with metrizamide in a double-blind study.     

MR脊髓成像：单次激发快速自旋回波序列技术的应用

目的：评价单次激发快速自旋回波序列（Single-shot TSE）在脊髓成像中的价值。材料与方法：400例腰背部疼痛患者行MR检查（Siemens1.5T Magnetom Symphorny）。所有扫描序列均配以脊柱相控阵线圈。扫描序列如下：（1）TSET2W;（2）TSET1W;（3）Single-shotTSE。结果：Single-shotTSE显示管优秀,病变轮廓勾画清晰。诊断椎管梗阻及压迫准确性为100％。对于常规MR序列显示不佳的囊肿有很好的显示,信噪比及对比度噪声比均大大提高。结论：单 激发快速自旋回波序列的优点：（1）成像时间短;（2）背景抑制好;（3）对病变显示的敏感性及准确性高。     

脊髓造影与CTM诊断腰椎间盘突出症与手术对照分析

目的：评价脊髓造影与CTM联合应用诊断腰椎间盘突出症的价值。方法：回顾性分析200例经手术证实的腰椎间盘突出症患者脊髓造影与CTM检查的影像资料。结果：单个腰椎间盘突出45例,多个腰椎间盘突出155例,脊髓造影诊断腰椎间盘突出191例,符合率95．5％,CTM诊断腰椎间盘突出症200例,符合率100％。结论：脊髓造影、CTM诊断腰椎间盘突出症敏感性高,并互相补充,能准确提供腰椎间盘突出的部位、方向、程度及分型等,为临床治疗方法、尤其是手术方式的选择提供重要的依据。     

直立位椎管造影对腰椎间盘突出的诊断价值

目的　评价直立位椎管造影对腰椎间盘突出的诊断价值。方法　经CT或MRI诊断的腰椎间盘突出 196例术前进行直立位椎管造影检查。结果　直立位椎管造影的诊断结果与CT或MRI基本符合 ,但有 7例直立位椎管造影发现L4～ 5椎间盘突出并伴有神经根受压 ,而CT或MRI未能显示。结论　直立位椎管造影对腰椎间盘突出的诊断可能优于CT或MRI ,尤其对L4 5椎间盘突出伴有神经根受压的病例。     

Contrast-enhanced MRI versus myelography and contrast-enhanced CT in postdiskectomy problems

Summary The differentiation between scar tissue and disk herniation is essential in postdiskectomy problems of the lumbar spine, since reoperation on scar tissue alone is often unfavourable. Epidural scar is a vascularized tissue, and enhancement can be seen after intravenous contrast injection, allowing differentiation from avascular disk material. Ten patients who had previously undergone surgery for lumbar disk herniation and with recurrent symptoms severe enought to warrant repeat surgery were examined by myelography, magnetic resonance imaging (MRI), and computed tomography (CT) before reoperation. MRI was performed with T1- and T2-weighted sequences in sagittal and axial projections before and after intravenous contrast injection. CT scans were obtained before and during intravenous contrast infusion. Reoperation revealed scar tissue, alone or together with disk, in 9 of 10 patients. Enhancement of scar but not of disk material was observed on MRI in 8 cases, but in none on CT. No enhancement of disk was seen with either modality. The correct diagnosis was given by MRI in 9 of 10 patients and by CT in 3 of 10. CT was superior to MRI in only 1 patient, who had a bony stenosis. Myelography could not separate disk from scar in any case. In conclusion, contrast-enhanced MRI was superior to MRI without contrast, CT before and after contrast, as well as myelography in discriminating disk from scar tissue.