Jinnah Sindh Medical University, Karachi, Sindh, Pakistan.
Liaquat University of Medical and Health Sciences, Jamshoro, Sindh, Pakistan.
BMJ Case Rep. 2020 Dec 21;13(12):e237610. doi: 10.1136/bcr-2020-237610.
Transient spinal shock is a previously unreported complication of intrathecal contrast. A 63-year-old man presented with the chief complaint of worsening back pain. Computed topography of lumbar spine without contrast showed a lytic lesion. After international normalized ratio (INR) correction, patient was sent for CT myelogram. After intrathecal contrast injection, the patient dropped his blood pressure profoundly and developed clinical manifestations of spinal shock. Emergent intravenous bolus fluids were initiated resulting in improvement in blood pressure. Patient's spinal shock resolved within hours. CT myelogram was normal except previously known lytic lesion. It was concluded that the transient shock was most likely due to contrast injection. We believe that this is the first reported case of transient spinal shock following CT myelogram using water-soluble iodinated non-ionic contrast agent administered intrathecally.
一过性脊髓休克是鞘内对比剂一个以前未报道的并发症。一位 63 岁男性以背痛加重为主诉就诊。腰椎 CT 平扫未见异常。国际标准化比值（INR）纠正后，患者行 CT 脊髓造影。鞘内注射对比剂后，患者血压明显下降，并出现脊髓休克的临床表现。立即静脉推注液体，血压改善。数小时后患者脊髓休克缓解。CT 脊髓造影除已知溶骨性病变外无异常。结论认为，短暂性休克最可能是由于对比剂注射引起。我们认为这是首例报告的 CT 脊髓造影使用水溶性碘非离子型对比剂鞘内给药后出现短暂性脊髓休克的病例。
