Inadvertent intrathecal use of ionic contrast agent

Eur Radiol. 2002 Dec:12 Suppl 3:S86-93. doi: 10.1007/s00330-002-1417-z. Epub 2002 Jun 4.


Intrathecal administration of ionic contrast media may cause severe and fatal neurotoxic reactions due to their hyperosmolarity and ionic nature. They are therefore strictly contraindicated for all radiologic applications involving the central nervous system (e.g., myelography). We present a case in which ioxitalamate was accidentally injected intrathecally. The patient recovered completely due to a combination of the different therapeutic options reported in the literature, including early mechanical ventilation and neuromuscular paralysis, aggressive control of seizures, elevation of head and trunk to prevent cephalad migration of contrast, steroids, cerebrospinal fluid drainage and lavage and prophylactic antibiotics.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Contrast Media / administration & dosage
  • Contrast Media / adverse effects*
  • Humans
  • Injections, Spinal
  • Iothalamic Acid / administration & dosage
  • Iothalamic Acid / adverse effects
  • Iothalamic Acid / analogs & derivatives*
  • Low Back Pain / complications
  • Low Back Pain / diagnosis
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Myoclonus / chemically induced
  • Tomography, X-Ray Computed


  • Contrast Media
  • Iothalamic Acid
  • ioxitalamic acid