J Korean Med Sci.  2010 Mar;25(3):505-508. 10.3346/jkms.2010.25.3.505.

Neurotoxic Manifestations of an Overdose Intrathecal Injection of Gadopentetate Dimeglumine

Affiliations
  • 1Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea. isbrzw@sch.ac.kr

Abstract

The intravenous administration of gadopentetate dimeglumine (GD) is relatively safe and rarely causes systemic toxicity in the course of routine imaging studies. However, the general safety of intrathecal GD has not been established. We report a very rare case of an overdose intrathecal GD injection presenting with neurotoxic manifestations, including a decreased level of consciousness, global aphasia, rigidity, and visual disturbance.

Keyword

Neurologic Manifestations; Injections, Spinal; Gadolinium DTPA

MeSH Terms

Adult
Aphasia/etiology/pathology/physiopathology
Brain/drug effects/pathology
*Contrast Media/administration & dosage/toxicity
*Gadolinium DTPA/administration & dosage/toxicity
Humans
*Injections, Spinal
Male
Muscle Rigidity/etiology/pathology/physiopathology
*Neurotoxicity Syndromes/etiology/pathology/physiopathology
Tomography, X-Ray Computed
Vision Disorders/etiology/pathology
Contrast Media
Gadolinium DTPA

Figure

  • Fig. 1 Brain CT images about 10 hr after the administration of GD showing diffuse high density throughout the subarachnoid space. (A) At the level of basal cisterns and (B) sylvian fissure.

  • Fig. 2 Conventional digital subtraction angiographies showing no definite vascular abnormality. (A) Right internal carotid artery (ICA), anteroposterior (AP) view. (B) Left ICA, AP view. (C, D) Left vertebral artery, AP (C) and lateral (D) view.

  • Fig. 3 Follow-up brain CT images on day 4 after admission. The diffuse high density throughout the subarachnoid space had disappeared. (A) At the level of basal cisterns and (B) sylvian fissure.


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