Neurotoxic manifestations of an overdose intrathecal injection of gadopentetate dimeglumine

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.

Keywords: Gadolinium DTPA; Injections, Spinal; Neurologic Manifestations.

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.