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Intrathecal iodinated contrast-induced transient spinal shock
  1. Abhi Chand Lohana1,
  2. Sejal Neel2,
  3. Vishal Deepak3 and
  4. Mark Schauer4
  1. 1Jinnah Sindh Medical University, Karachi, Sindh, Pakistan
  2. 2Liaquat University of Medical and Health Sciences, Jamshoro, Sindh, Pakistan
  3. 3Pulmonary and Critical Care Medicine, West Virginia University School of Medicine, Morgantown, West Virginia, USA
  4. 4Internal Medicine, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan, USA
  1. Correspondence to Dr Vishal Deepak; deepak.vishal{at}live.com

Abstract

Transient spinal shock is a previously unreported complication of intrathecal contrast. A 63-year-old man presented with the chief complaint of worsening back pain. Computed topography of lumbar spine without contrast showed a lytic lesion. After international normalized ratio (INR) correction, patient was sent for CT myelogram. After intrathecal contrast injection, the patient dropped his blood pressure profoundly and developed clinical manifestations of spinal shock. Emergent intravenous bolus fluids were initiated resulting in improvement in blood pressure. Patient’s spinal shock resolved within hours. CT myelogram was normal except previously known lytic lesion. It was concluded that the transient shock was most likely due to contrast injection. We believe that this is the first reported case of transient spinal shock following CT myelogram using water-soluble iodinated non-ionic contrast agent administered intrathecally.

  • unwanted effects / adverse reactions
  • contraindications and precautions
  • adult intensive care
  • neuroimaging
  • spinal cord

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Footnotes

  • Contributors ACL and SN: literature review and manuscript writing. VD: review and contribution to manuscript and changes in the revision of the manuscript. MS: review and contribution to manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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