Contrast-induced encephalopathy

Babalova, L; Ruzinak, R; Ballova, J; Sivak, S; Kantorová, Ema; Kurca, E; Zeleňák, Kamil; Nosáľ, Vladimír

doi:10.4149/bll_2021_098

Cited by 13 publications

(10 citation statements)

References 27 publications

(33 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These may include gastrointestinal symptoms, such as nausea, vomiting, and abdominal distention; psychiatric symptoms, such as confusion, delirium, and loss of consciousness; and neurological impairments, such as limb movement disorders, optic nerve and motoneural dysfunction, memory loss, and even cardiopulmonary arrest. [13][14][15] Clinical professionals may encounter challenges in diagnosing or differentiating certain symptoms of CIE, as they can be easily mistaken for those of primary cerebrovascular lesions. Brain ischemia or cerebral hemorrhage are 2 potential imaging findings in CIE patients.…”

Section: Discussionmentioning

confidence: 99%

After 3 months of medication balloon therapy, a patient who had contrast-induced encephalopathy recovered: A case report

et al. 2023

View full text Add to dashboard Cite

Rationale: Iodinated contrast agents are extensively employed in clinical settings, with allergic reactions and renal impairment being the most prevalent adverse events. Contrast-induced encephalopathy (CIE) can present with heterogeneous clinical features, making diagnosis challenging. Prior studies on CIE have primarily documented rapid recovery within several days. However, this paper describes a case of CIE in a patient whose clinical symptoms took 3 months to fully abate. Patient concerns: A female patient, aged 54 years, received drug-coated balloon therapy for stenosis in a branch of the anterior descending coronary artery. Unfortunately, the patient developed CIE, which initially manifested as visual disturbances and subsequently progressed to gastrointestinal and limb movement issues, as well as an altered mental status, all of which occurred within a 24-hour period during hospitalization. Diagnoses: The patient was diagnosed with CIE after cerebral hemorrhage, and cerebral edema was ruled out based on the history of contrast medium administration and radiographic exams. Interventions and outcomes: Dexamethasone (10 mg/d), mannitol (100 mL/d), betahistine (500 mL), trazodone (25 mg), and hydration supplementation were given to treat CIE-related symptoms. Aspirin and clopidogrel were administered for the management of the cardiovascular ailment. The neurologist prescribed neurotrophic agents, namely, cytarabine and methylcobalamin, based on the cerebral magnetic resonance imaging findings. Despite the treatment, the patient’s ocular symptoms, including blurry vision, diplopia, and impaired intraocular retraction, persisted. Furthermore, the patient’s mental state was altered, and she continued to exhibit a depressive state during her 1-month follow-up visit. Lessons: CIE is a comparatively infrequent ailment, and its prompt identification and management are of paramount importance. Although the treatments for CIE are primarily symptomatic, it is crucial to acknowledge that the symptoms may not always subside quickly within a short duration. In conjunction with pharmacotherapy, counseling should be offered to address patients’ mental health.

show abstract

Section: Discussionmentioning

confidence: 99%

After 3 months of medication balloon therapy, a patient who had contrast-induced encephalopathy recovered: A case report

et al. 2023

View full text Add to dashboard Cite

show abstract

“…CIE is a rare adverse effect taking place after procedures applying iodinated contrast media, which is predominantly associated with endovascular intervention or diagnostic imaging directly involving the cerebral circulation [ 11 – 14 ], and relatively less common during coronary angiography [ 15 – 17 ]. Different types (high-/ low-osmolality, ionic or nonionic) and dosages of contrast media can lead to CIE in patients with or without cardiovascular risk factors [ 5 – 27 ].…”

Section: Discussionmentioning

confidence: 99%

Flow diagram of the differential diagnosis and clinical decision making in a rare case of contrast-induced encephalopathy following cardiac catheterization: a case report

Sun

Yuan

et al. 2023

BMC Cardiovasc Disord

View full text Add to dashboard Cite

Background Contrast-induced encephalopathy (CIE) is considered as an uncommon complication following cardiac catheterization. Due to the varied manifestations, CIE has no formal diagnostic criteria. In fact, the incidence of CIE may be greatly underestimated because of the difficulty in its differential diagnosis with other cerebrovascular complications. Thus, making a flow diagram according to patients’ clinical symptoms and examinations after cardiac catheterization to help clinicians diagnose CIE is important and needed. Case presentation In this report, we describe a case of probable CIE in a 66-year-old Chinese man with hypertension who underwent cardiac catheterization with stents placement in the bifurcation lesion, during which 80 ml iopromide contrast was used. About 2 h following the procedure, the patient lost his consciousness suddenly and suffered from a status epilepticus. Malignant arrhythmias were not found through continuous electrocardiogram monitoring, but mild ST-segment elevation was displayed in leads I and aVL. The echocardiography, plasma glucose and electrolyte levels were normal. Emergency re-angiography with percutaneous transluminal coronary angioplasty was performed in the culprit lesion, which involved 60 ml iopromide contrast. However, the patient remained unconsciousness and epilepticus. Non-contrast computed tomography (CT) of the head showed cortical and subarachnoid enhancement as well as prolonged retention of contrast media in the middle cerebral artery. With supportive treatment of intravenous hydration, sedative and dehydrant, the patient recovered 3 h later and finally discharged without any neurological deficits. Conclusions CIE is an acute reversible encephalopathy induced by contrast media. It is exceptionally challenging to make the diagnosis of CIE following cardiac catheterization since there is a lack of consensus on the definition of CIE. Via this case we reviewed the related literatures, through which a flow diagram of the differential diagnosis and clinical decision making was given, which could help to differentiate CIE from other neurological complications following cardiac catheterization.

show abstract

“…Managing CIE typically involves symptomatic treatment and ensuring proper hydration, which are the primary approaches for addressing this condition. [ 27 ]…”

Section: Extubation and Recoverymentioning

confidence: 99%

Periprocedural management of patients presenting for neurointerventional procedures using flow diverters for complex intracranial aneurysms: An anesthetist’s perspective - A narrative review

Sree,

Hrishi,

Praveen

et al. 2024

Brain Circulation

View full text Add to dashboard Cite

Complex intracranial aneurysms pose significant challenges in the realm of neurointervention, necessitating meticulous planning and execution. This article highlights the crucial roles played by anesthetists in these procedures, including patient assessment, anesthesia planning, and continuous monitoring and maintaining hemodynamic stability, which are pivotal in optimizing patient safety. Understanding these complex procedures and their complications will aid the anesthetist in delivering optimal care and in foreseeing and managing the potential associated complications. The anesthetist’s responsibility extends beyond the procedure itself to postprocedure care, ensuring a smooth transition to the recovery phase. Successful periprocedural anesthetic management in flow diverter interventions for complex intracranial aneurysms hinges on carefully orchestrating these elements. Moreover, effective communication and collaboration with the interventional neuroradiologist and the procedural team are emphasized, as they contribute significantly to procedural success. This article underscores the essential requirement for a multidisciplinary team approach when managing patients undergoing neurointerventions. In this collaborative framework, the expertise of the anesthetist harmoniously complements the skills and knowledge of other team members, contributing to the overall success and safety of these procedures. By providing a high level of care throughout the periprocedural period, anesthetists play a pivotal role in enhancing patient outcomes and minimizing the risks associated with these intricate procedures. In conclusion, the periprocedural anesthetic management of neurointervention using flow diverters for complex intracranial aneurysms is a multifaceted process that requires expertise, communication, and collaboration.

show abstract

Contrast-induced encephalopathy

Cited by 13 publications

References 27 publications

After 3 months of medication balloon therapy, a patient who had contrast-induced encephalopathy recovered: A case report

After 3 months of medication balloon therapy, a patient who had contrast-induced encephalopathy recovered: A case report

Flow diagram of the differential diagnosis and clinical decision making in a rare case of contrast-induced encephalopathy following cardiac catheterization: a case report

Periprocedural management of patients presenting for neurointerventional procedures using flow diverters for complex intracranial aneurysms: An anesthetist’s perspective - A narrative review

Contact Info

Product

Resources

About