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Does Myodil introduced for ventriculography lead to symptomatic lumbar arachnoiditis?

Lysholm Department of Radiology, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK

Although there is a substantial body of evidence implicating Myodil or Pantopaque as a cause of lumbar arachnoiditis, assessment of the clinically based evidence is complicated by the additional potentially causative factors present in a high proportion of cases. These include pre-existing spinal pathology, traumatic lumbar puncture and surgery. The aim of this retrospective study was to attempt to ascertain whether Myodil introduced via ventricular catheter was associated with subsequent development of symptomatic lumbar arachnoiditis. In 222 patients in whom clinical records were reviewed there was no excess of back pain following ventriculography compared to the general population. Myodil ventriculography does not appear to be a major cause of symptomatic lumbar arachnoiditis. Several unavoidable problems with the methodology of this study are discussed.

Key Words: Arachnoiditis • Myelography • Myodil • Pantopaque

Received for publication March 2, 1992. Accepted for publication June 3, 1992.