Intraventricular Gadoteric Acid Intoxication: First Report.

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Intraventricular Gadoteric Acid Intoxication: First Report.

World Neurosurg. 2017 Dec 29;:

Authors: Turk O, Ozdemir NG, Atci IB, Saygi T, Yilmaz H, Antar V

Abstract
Gadolinium based contrast agents are relatively safe for use in MRI of nervous system pathology. Few reports have been reported regarding the severe adverse effects. These are mostly mild anaphylactoid reactions, especially in the vulnerable group. We report a case of an adverse effect of gadoteric acid concerning the misuse as intraventricular administration. To our knowledge, this is the first report related with the intraventricular spillage and its results. A 38-year-old male patient with a complaint of headache and drowsiness was admitted to hospital after which cranial magnetic resonance imaging revealed that he had a posterior fossa mass. An operation was performed with the catheterization of the lateral ventricule as a safety device at the beginning, and later mass was evacuated gross totally. Frozen pathology result showed the tumor was medulloblastoma. At the first post-operative day a control contrasted cranial and total spinal MRI was planned. He was observed to have a tonic-clonic generalized seizure soon after returning to the ward. After giving the acute management with antiepileptics and the patient was stabilized, it was recognized that the patient was administered the contrast media by the intraventricular route. Symptomatic treatment as well as CSF irrigation by the external ventricular drainage helped the patient's improvement. After a week his symptoms were relieved and he had no complications during out-patient controls. In addition to formal basic supportive treatment, CSF irrigation of the toxic contrast material is the best management method in case of such an unexpected mis-administration of gadoteric acid.

PMID: 29292188 [PubMed - as supplied by publisher]

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