Psychosyndrome following intrathecal application of metrizamide

A total of 520 intrahecal examinations were performed with metrizamide in 200 patients, followed by computerized tomography 6 hours, 12, 24, 48 and 96 hours after the application of metrizamide; a small group of patients was subjected to a follow-up CT examination 4 months after myelography. The results were evaluated optically. Densities were measured in the regions of the cerebral cortex, medullary layer, cisterns of Sylvius (cisterna fossae lateralis cerebri) and intercerebral fissure. The results of optical evaluation of the CT pattern did not correspond with the density measurements; the medullary layer presented an optically hypodense appearance. Densities did not differ significantly from normal values. Occurrence of psychosyndrome seemed to depend not only on the amount of contrast medium administered but also on the site of the examined intrathecal region. No definite dependence was established between the psychosyndrome and the age of the patient concerned, as well as on the density values, especially in the region of the cerebral cortex. The authors point out that during the psychosyndrome the patients are in a condition resembling a state of aphasia, a fact which has hardly been reported in literature to date. (orig.)