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February 1984

Cortical Blindness After Metrizamide Myelography: Report of a Case and Proposed Pathophysiologic Mechanism

Author Affiliations

From the Departments of Radiology (Drs Smirniotopoulos, Schellinger, and Borts) and Neurology (Drs Murphy and Kurtzke), Georgetown University Hospital, and the Department of Neurology, Veterans Administration Hospital (Dr Kurtzke), Washington, DC.

Arch Neurol. 1984;41(2):224-226. doi:10.1001/archneur.1984.04050140126042

• Metrizamide, a nonionic, water-soluble contrast medium, has been increasingly used for myelography. We saw a patient with cortical blindness, seizure, organic psychosis, and asterixis after undergoing attempted metrizamide myelography via C1-2 puncture. Computed tomography demonstrated early penetrance of metrizamide into the brain parenchyma, most prominently in the occipital lobes. A mechanism of direct metrizamide neurotoxicity was proposed.

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