Experimental Pantopaque ventriculography

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✓ The injection of Pantopaque into the ventricles of normal and hydrocephalic dogs produced a variety of acute and chronic pathological changes. Multiple granulomatous lesions developed in the ventricular wall and the surrounding brain parenchyma, choroid plexus, cranial nerves, and arachnoid membrane. Adhesions formed in several areas of the ventricles, and Pantopaque became encysted in the third ventricle and tips of the temporal horns. In general there were more serious changes in the animals that had a greater degree of hydrocephalus. Relatively mild lesions were noted in normal animals.

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Address reprint requests to: Dr. Ronald G. Clark, Department of Biological Structure, University of Miami School of Medicine, 1600 N.W. 10th Avenue, Miami, Florida 33152.

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    Left: Transverse section of the frontal horn from an animal 7 months after Pantopaque ventriculography. Note the severe inflammatory response that extends into the neighboring brain parenchyma in both the medial and lateral walls. No normal ependyma remains. SP = septum pellucidum; CN = caudate nucleus. H & E, ×20. Right: Transverse section of the inferior angle of the frontal horn from another animal 7 months after Pantopaque ventriculography. Note the severe inflammatory lesions in the ventricular wall and surrounding brain parenchyma. No normal ependyma remains. H & E, ×20.

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    Transverse sections at the level of the lateral recess of the 4th ventricle from two animals 6 and 7 months after Pantopaque ventriculography. Left: Granulomatous lesions and perivascular infiltrates in the choroid plexus, cerebellum (CB), and dorsal cochlear nucleus (DCN). H & E, ×11. Right: Granulomatous lesions and perivascular infiltrates are seen in the 8th nerve (N8) and choroid plexus (CP). H & E, ×36.

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    Transverse section of the choroid plexus in the body of the lateral ventricle from an animal 1 day after Pantopaque ventriculography. Note the large number of polymorphonuclear leucocytes invading the ependyma and underlying stroma. H & E, ×60.

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    Transverse section at the level of the 4th ventricle from an animal 7 months after Pantopaque ventriculography. Note the extensive granulomatous lesions in the choroid plexus. H & E, ×12.

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    Transverse section of the basal cisterns (trabecular meshwork of the arachnoid membrane) from an animal 5 months after Pantopaque ventriculography. Note the granulomatous lesions and perivascular infiltrates. H & E, ×19.

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    Left: X-ray of Dog D-31 at the time of Pantopaque ventriculography. The animal had a moderate degree of dilation of the ventricular system. Right: Gross brain section of Dog D-31 necropsied 7 months after Pantopaque ventriculography. The animal had hydrocephalus that was of a much greater magnitude than that indicated at the time of ventriculography.

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    Gross brain sections of a dog necropsied 6 months after Pantopaque ventriculography. The animal had hydrocephalus that was of a much greater magnitude than that observed at the time of ventriculography. Left: Note the Pantopaque-filled cysts in the tips of the inferior horns (arrows). Right: Note the large Pantopaque-filled cyst in the third ventricle (arrow).

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    Transverse section of the aqueduct of Sylvius from an animal 7 months after Pantopaque ventriculography. Note the severe stenosis caused by the inflammatory reaction to the Pantopaque. Very little normal ependyma is left. H & E, ×35.

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    Left: Gross brain section of an animal 6 months after Pantopaque ventriculography. Note the cyst in the third ventricle in which there is a large granulomatous mass (arrow). Right: Gross brain section of an animal 4 months after Pantopaque ventriculography. Note the cyst in the third ventricle in which there is a large granulomatous mass protruding ventrally through the ventricular wall (arrow).

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    Transverse section of the cerebral cortex from an animal 1 day after Pantopaque ventriculography. Note the large area of necrosis located at the dorsal aspect of the needle track. H & E, ×9.

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