Central ventriculography with Dimer-X.

Abstract

The intraventricular injection of methyl glucamine iocarmate (Dimer-X) does not lead to permanent histological changes of the ependyma or the meninges in animal experiments. Our own investigations in cats revealed discrete infiltrations of leucocytes and lymphocytes in the region of the basal meninges between 3 and 24 hours after the intraventricular injection of the contrast medium. The histological changes are reversible and no longer visible after a period of 3 days. Even 5 weeks after the injection no histological alterations due to the contrast medium could be found. After the favourable results of the animal experiments, 109 clinical examinations were carried out with Dimer-X since 1971. Our technique of central ventriculography is based on that of Azambuja et al. which was first described in 1956. The indication for central ventriculography with water-soluble contrast media is set by space-occupying lesions in the region of the unpaired ventricles especially in the midbrain or the posterior fossa. The great advantage of this method lies in the good contrast achieved in the radiological visualization of the ventricles which are often narrowed by tumours. The possible side effects are similar to those occurring with pneumoencephalography, chiefly nausea and vomiting immediately after the examination. The most serious complication with resorbable contrast media is the occurrence of seizures. However, these can only appear if the contrast medium comes in contact with the surface of the brain during the examination. If the correct technique is used—i.e. a thin catheter is placed in the third ventricle—such a complication may be avoided.