LAUSR

Intravenously applied gadolinium-based contrast agents (GBCA) are widely used for magnetic resonance imaging (MRI) diagnostics in all clinical disciplines. They are considered safe with overall rates of less than 2.4% of acute allergic and non-allergic reactions [1]. Severe adverse effects, such as cardiac arrest [2] occur in 0.0–0.03% when administered in commonly used dosages. Intrathecal use of GBCA has been used off-label for several indications, especially for diagnosis of cerebrospinal fluid (CSF) leaks and is mostly well-tolerated [3]. This article reports an unusual case with acute onset encephalopathy and cardiac arrest following diagnostic intrathecal administration of gadobutrol.