Transient contrast encephalopathy after carotid angiography mimicking diffuse subarachnoid haemorrhage

Potsi, Stamatia; Chourmouzi, Danai; Moumtzouoglou, Anestis; Nikiforaki, Aikaterini; Gkouvas, Kostas; Drevelegas, Antonios

doi:10.1007/s10072-011-0765-3

Cited by 54 publications

(57 citation statements)

References 13 publications

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“…However, the extent of swelling was too large for seizure-induced brain swelling, and there was a lack of corresponding changes on the MRI [8]. Subarachnoid hemorrhage was also ruled out by the absence of any hyperdensity in the sulci on the initial nonenhanced CT [3, 9, 10]. Hyperperfusion syndrome was unlikely because no carotid revascularization was performed in this patient.…”

Section: Discussionmentioning

confidence: 99%

Contrast-Induced Neurotoxicity following Cardiac Catheterization

Law

Panichpisal

Demede

et al. 2012

Case Reports in Medicine

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We report a case of probable contrast-induced neurotoxicity that followed a technically challenging cardiac catheterization in a 69-year-old woman. The procedure had involved the administration of a large cumulative dose of an iodinated, nonionic contrast medium into the innominate artery: twelve hours following the catheterization, the patient developed a seizure followed by a left hemiplegia, and an initial computed tomography (CT) scan showed sulcal effacement in the right cerebral hemisphere due to cerebral swelling. The patient's clinical symptoms resolved within 24 hours, and magnetic resonance imaging at 32 hours showed resolution of swelling. Contrast-induced neurotoxicity should be found in the differential diagnosis of acute neurological deficits occurring after radiological procedures involving iodinated contrast media, whether ionic or nonionic.

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Section: Discussionmentioning

confidence: 99%

Contrast-Induced Neurotoxicity following Cardiac Catheterization

Law

Panichpisal

Demede

et al. 2012

Case Reports in Medicine

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“…One study proposed 170 mL as the maximal recommended dose for coronary angiograms to prevent CIE [1]. However, very small doses of contrast media – as little as 25 mL – for local injection into the carotid artery have been reported to cause CIE [20]. CIE resulting from Iohexol administration following coronary angiogram is rare but has been noted before [13].…”

Section: Discussionmentioning

confidence: 99%

Contrast-Induced Encephalopathy following Coronary Angiography with No Radiological Features: A Case Report and Literature Review

Dattani

Tay

et al. 2018

Cardiology

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Contrast-induced encephalopathy (CIE) following coronary angiography (CAG) is a very rare complication. Radiological signs such as cerebral oedema and cortical enhancement are of great importance in the diagnosis. We report a case of probable CIE in a 76-year-old gentleman following a normal diagnostic CAG that involved 120 mL of the iodinated contrast agent iohexol (Omnipaque 300). At 90 min postprocedure he became acutely confused with a normal non-contrast CT of the head. After 9 days of conservative treatment, the patient recovered spontaneously with no neurological deficits. This case and a review of the literature highlights that contrast-induced neurotoxicity may not always present with the typical radiological signs that are described in association with CIE. Given the excellent prognosis with supportive management only, interventional cardiologists should be well aware of this condition despite the absence of radiological features.

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“…Seizures, alterations in mental state, cortical blindness and ophthalmoplegia are known side effects of contrast agents [2, 7–9]. It is difficult to distinguish CIE from other well-known complications such as SAH [7, 10]. Here, we report self-limiting encephalopathy in 2 patients following the administration of intracoronary iopromide after coronary angiography, which presented very likely as SAH.…”

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confidence: 90%