Complex imaging features of accidental cerebral intraventricular gadolinium administration

Report of 2 cases

Restricted access

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $505.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00

Gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA) is a contrast agent commonly used for enhancing MRI. In this paper, the authors report on 2 cases of postoperative inadvertent administration of Gd-DTPA directly into a ventriculostomy tubing side port that was mistaken for intravenous tubing. Both cases demonstrated a low signal on MRI throughout the ventricular system and dependent portions of the subarachnoid spaces, which was originally believed to be CSF with areas of T1 shortening in the nondependent portions of the subarachnoid spaces, and misinterpreted as basal leptomeningeal enhancement and meningitis. The authors propose that the appearance of profound T1 hypointensity within the ventricles and diffuse susceptibility artifact along the ependyma is pathognomonic of intraventricular Gd-DTPA and should be recognized.

Abbreviation used in this paper:Gd-DTPA = gadolinium diethylenetriamine pentaacetic acid.
Article Information

Contributor Notes

Address correspondence to: Nita Nayak, M.D., University of California, Los Angeles, 757 Westwood Boulevard, Suite 1638, Los Angeles, California 90095. email: include this information when citing this paper: published online March 15, 2013; DOI: 10.3171/2013.2.JNS121712.
  • 1

    Bronen RASze G: Magnetic resonance imaging contrast agents: theory and application to the central nervous system. J Neurosurg 73:8208391990

    • Search Google Scholar
    • Export Citation
  • 2

    Kapoor RLiu JDevasenapathy AGordin V: Gadolinium encephalopathy after intrathecal gadolinium injection. Pain Physician 13:E321E3262010

    • Search Google Scholar
    • Export Citation
  • 3

    Park KWIm SBKim BTHwang SCPark JSShin WH: Neurotoxic manifestations of an overdose intrathecal injection of gadopentetate dimeglumine. J Korean Med Sci 25:5055082010

    • Search Google Scholar
    • Export Citation
  • 4

    Ray DECavanagh JBNolan CCWilliams SCR: Neurotoxic effects of gadopentetate dimeglumine: behavioral disturbance and morphology after intracerebroventricular injection in rats. AJNR Am J Neuroradiol 17:3653731996

    • Search Google Scholar
    • Export Citation
  • 5

    Runge VM: Safety of approved MR contrast media for intravenous injection. J Magn Reson Imaging 12:2052132001

  • 6

    Xie DKennan RPGore JC: Measurements of the relaxivity of gadolinium chelates in tissues in vivo. Proc Intl Soc Mag Reson 9:8902001

    • Search Google Scholar
    • Export Citation


All Time Past Year Past 30 Days
Abstract Views 225 147 15
Full Text Views 145 13 1
PDF Downloads 182 12 0
EPUB Downloads 0 0 0
Google Scholar