Biomedical subjects
Publications and source records attributed to O Sortland.
In 170 patients 184 ventriculographies with water-soluble contrast media were carried out, 60 examinations with meglumine iocarmate (Dimer-X) and 124 with metrizamide (Amipaque). Grand mal seizures occurred in one patient following the injection of meglumine iocarmate. The indications, technique and diagnostic results are reported.
The technique and results of cerebello-pontine angle cisternography with metrizamide (Amipaque) in 34 patients are reported. Fourteen tumors were diagnosed. The internal auditory canal was normal in 19 patients, and in all of them the facial and statoacoustic nerves were visible. One examination was unsuccessful. No serious complications occurred. Headache was recorded in 76 per cent and transient EEG disturbance in 32 per cent of the patients.
Two types of EEG abnormalities were recorded after myelography, cisternography and ventriculography with metrizamide (Amipaque) in 292 patients. One, probably without clinical significance, occurred in the EEG of 36 patients as theta waves the following day. The other was of a more serious nature and was recorded as paroxysms of delta waves or spikes in the EEG of 11 patients minutes or some few hours after the myelography. One of these patients developed epileptic seizures.
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Metrizamide seems to be a suitable contrast medium for ventriculography and myelography. This contrast medium is less toxic and far less epileptogenic and spasmogenic than the other water-soluble contrast media in current use. No serious complications were noted in the present series. Transient changes in EEG were recorded, mainly with cervical myelographies. However, it is too early to evaluate the long-term side effects.
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Since 1983 iohexol has been routinely used for myelography in our hospital and 1,650 myelographies have been performed. The first 331 patients with lumbar myelography were included in a follow-up study. Headache was observed in 26 per cent, nausea in 12 per cent and vertigo in 6 per cent of the patients, a frequency very similar to that observed in an earlier study of side effects following spinal puncture. Severe reactions were not seen. Three patients had radicular symptoms and 3 patients had minor mental symptoms possibly caused by the contrast medium. It is concluded that most side effects are related to the spinal puncture and that iohexol probably can be used with safety in out-patients.
In a prospective study of 48 patients suspected to have splenic injury, the diagnostic value of computed tomography (CT) and scintigraphy was investigated. Both methods showed high sensitivity, demonstrating 27 of 28 ruptures. The specificity was 100% for CT and 80% for scintigraphy, since the latter method gave four false-positive diagnoses with regard to rupture and bleeding. Scintigraphy, however, has advantages over CT in children and noncooperative adults and is highly suitable in local trauma to the left lower thorax. CT is preferable in cases with possible trauma to multiple organs, such as commonly occurs in traffic accidents, and also provides a rough estimate of the extent of bleeding.