Medical Questions » Radiology Questions » Question No. 836
| Question: | My husband had a myelogram three weeks ago and has suffered from severe headaches and nausea ever since. Is this a normal side-effect of a myelogram? Can these side effects be prevented or treated? |
| Answer: | Myelograms have largely been superseded by CAT and MRI scans, which give much the same information with fewer side effects, but sometimes a myelogram is still necessary to diagnose particular problems.
When a myelogram is performed, a needle is pushed through the skin low down on the back, and between two vertebrae so that the tip of the needle is in the spinal canal. This canal contains the spinal cord (which carries all the nerves from the brain to the body) and a fluid called cerebrospinal fluid.
A small amount of fluid is removed, and an equal amount of a dye is injected into the spinal canal. The patient is then tilted so that the dye runs up the canal. This dye is visible on X-rays, and as the patient is tilted backwards and forwards, numerous X-rays are taken of the back to see where the dye moves to. If there is a blockage in the spinal canal caused by a slipped disc, or any abnormality of the spinal cord, it should show up on the X-rays.
At the end of the procedure, the dye is run back down to the area where the needle has been insetted, and as much dye as possible is removed, and an equal amount of saline solution is injected to keep the volume and pressure of the cerebrospinal fluid constant.
If the pressure changes significantly, a headache will occur. A headache (sometimes quite severe) is normal for a few days after the procedure, and these headaches are notoriously resistant to any treatment, but three weeks is excessive. It may be that too much or too little fluid was injected into, or removed from, the spinal canal, and this change in fluid pressure is causing the headache.
The other possibility is that the disease leading to the myelogram being performed may be responsible for the headache. In either case, you should return to see the specialist who ordered the myelogram as soon as possible for further assessment.
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