A 68-year-old woman with controlled hypertension, and degenerative joint disease of the spine for which she had undergone several myelograms and three surgeries 30-32 years earlier, presented with a 2 year history of painless, oblique, binocular diplopia. Her prior ophthalmic evaluations were consistent with an isolated left trochlear nerve paresis. She had magnetic resonance imaging (MRI) showing multiple foci of T1-weighted hyperintensities around the midbrain and brainstem thought to represent subarachnoid fat from a ruptured dermoid cyst. An extensive evaluation revealed a left trochlear nerve paresis as well as diminished sensation in the distributions of the first and second divisions of the left trigeminal nerve. Review of her MRI and history of myelograms raised the possibility of focal inflammation from intrathecal iophendylate (Pantopaque®). Repeat MRI was obtained that showed T1-weighted hyperintensities similar to her previous MRI, but in this study, T1-weighted fat suppression imaging also was performed and revealed these foci to be of low signal intensity, consistent with retained iophendylate.

01 Aug 2022·Cureus

Pantopaque: Does It Still Migrate With Gravity After 30 Years?

Author: Ma, Frank ; Liu, Antonio K ; Bui, Linh ; Jacobs, Jamie

Pantopaque was an oil-based positive contrast media used in central nervous system imaging before the use of water-soluble contrast agents. It is no longer used due to side effects, including arachnoiditis. Prior studies have indicated that remnants of pantopaque can be seen in modern radiographic imaging, including CT and MRI. With its use obsolete, these remnants have been increasingly mislabeled from "tumor" to "shot gun pellets". An understanding of this historic modality will usually lead to the correct diagnosis.

01 Sep 2021·Journal of Oral and Maxillofacial Surgery

Can Myelography Residues Have an Incidental Finding on Panoramic Radiography? Two Case Reports

Author: Atasoy Sındıraç, Aysun ; Uyanık, Sadık Ahmet ; Köse, Taha Emre ; Günaçar, Dilara Nil

Oil-based contrast medium agents (Iofendylate) are cleared from cerebrospinal fluid very slowly. But it may remain within the tissues of the central nervous system. These substances, which were used for purposes such as myelography, cisternography, and ventriculography approximately 70 years ago and were replaced by water-soluble agents after thirty years, can rarely be detected incidentally. In this report, by presenting the intracranial radiopacities seen in 2 patients, it is aimed to increase awareness that these myeloid residues, which are rarely seen in panoramic radiography, can be diagnosed by clinicians.

100 Deals associated with Iophendylate

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KEGG	Wiki	ATC	Drug Bank
-	Iophendylate	V08AD04	DB01187

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