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To the Editor:—
For at least 30 years methylene blue has been used by neurosurgeons as a dye to color the cerebrospinal fluid. In most instances the dye has been injected into hydrocephalic ventricles in the effort to demonstrate the presence or absence of a block somewhere within the ventricular system. Under these circumstances the dye becomes almost immediately very dilute. Emboldened by the use of the dye in this fashion, neurosurgeons have, on occasion, injected the dye directly or in diluted form into the lumbar subarachnoid space. We recently have used the dye in this fashion drawn from a 10-cc. ampul of aqueous 1% methylene blue solution as used intravenously. In our own case 1 cc. of the dye was diluted in 25 cc. of spinal fluid and was then injected. Shortly thereafter there was discomfort, and then followed a rather profound paraplegia, which fortunately cleared in the course
Evans JP. WARNING AGAINST INTRATHECAL USE OF METHYLENE BLUE. JAMA. 1959;169(5):526. doi:10.1001/jama.1959.03000220106025
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