title: Hemorrhagic complications after the lumbar injection of chymopapain.
abstract: There are few reports of hemorrhagic central nervous system complications after chymopapain injection in humans. Two patients are reported who developed hemorrhagic complications after the lumbar injection of chymopapain. The first developed a hemorrhagic encephalomyelopathy followed by clinically suspected acute arachnoiditis, which responded to high doses of dexamethasone. The second patient developed subarachnoid hemorrhage secondary to vertebral artery aneurysm rupture after the injection of chymopapain.
mesh_terms: D000328:Adult; D001100:Arachnoiditis / Q000139:chemically induced; D002543:Cerebral Hemorrhage / Q000139:chemically induced*; D002917:Chymopapain / Q000009:adverse effects*; D003974:Diatrizoate Meglumine / Q000009:adverse effects; D004347:Drug Interactions; D010450:Endopeptidases / Q000009:adverse effects*; D006470:Hemorrhage / Q000139:chemically induced*; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000188:drug therapy; D007482:Iothalamate Meglumine / Q000009:adverse effects; D008297:Male; D008793:Metrizamide / Q000009:adverse effects; D013118:Spinal Cord Diseases / Q000139:chemically induced*; D013345:Subarachnoid Hemorrhage / Q000139:chemically induced
chemical_list: D003974:Diatrizoate Meglumine; D010450:Endopeptidases; D002917:Chymopapain; D008793:Metrizamide; D007482:Iothalamate Meglumine