Radiology, Vol 138, 625-627, Copyright © 1981 by Radiological Society of North America
Incidence of adverse effects following metrizamide myelography in nonambulatory and ambulatory patients
RH Sykes, W Wasenaar and P Clark
A study was done to determine whether cerebrospinal fluid loss through a
lumbar puncture tear or metrizamide contact with central nervous system
tissue is the more important contributor to postmyelographic headache. To
do this, the influence of postmyelographic positioning was recorded in 43
ambulatory and 43 nonambulatory (confined to bed for 24 hours after the
procedure) patients. The incidence of headache was 10.5% in the ambulatory
group and 43.6% in the nonambulatory group (p less than 0.01). There were
no significant differences between the two groups with respect to leg and
back pain or nausea and vomiting. It is concluded that irritation of the
central nervous system by metrizamide is more important as a causative
factor of postmyelographic headache than is cerebrospinal fluid leakage.
Following metrizamide myelography, patients can be encouraged to be
ambulatory without any increase in the incidence of adverse effects.
