Transient Cortical Blindness Following Vertebral Angiography: A Case Report

Lo, Lai Wan; Chan, Ho Fung; Fai, Ka; Cheng, Lik Fai; Chan, T. K.

doi:10.5469/neuroint.2015.10.1.39

Cited by 14 publications

(18 citation statements)

References 8 publications

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“…In the present study, the vision of patients in the transient cortical blindness group was completely restored within 4 days. Although there have been many previous case reports or small case series of transient cortical blindness, few researchers have focused specifically on the risk factors for transient cortical blindness after cerebral angiography procedures (3–5). In this study we examined a much larger cohort who underwent cerebral angiography at five high-volume medical centers with the aim of identifying these risk factors.…”

Section: Discussionmentioning

confidence: 99%

“…Identifying the risk factors for transient cortical blindness after cerebral angiography remains an important issue and would provide helpful reference points for physicians. However, most authors of previous studies of transient cortical blindness have drawn their conclusion on the basis of single-center data and a limited number of cases (3–5). This retrospective study employed a large multicenter sample of patients to identify the risk factors related to transient cortical blindness after cerebral angiography.…”

Section: Introductionmentioning

confidence: 99%

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Risk Factors of Transient Cortical Blindness After Cerebral Angiography: A Multicenter Study

Liang

Liu

et al. 2019

Front. Neurol.

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Background: Although transient cortical blindness is a rare complication following cerebral angiography, identification of risk factors for the development of transient cortical blindness after cerebral angiography is an important clinical issue.Material and methods: Between January 2008 and April 2018, 5,126 patients at five high-volume medical centers who underwent cerebral angiography procedures were enrolled in this multicenter cohort study. Patient baseline characteristics and surgery-related factors were analyzed. We used multivariate logistic regression to examine factors associated with transient cortical blindness.Results: Eighteen patients (0.35%) in the total cohort of 5,126 suffered transient cortical blindness. After univariate statistical analysis, no significant differences were determined between the transient cortical blindness group and the control group regarding gender (p = 0.454), age (p = 0.872), smoking (p = 0.170), diabetes (p = 0.800), and hypertension (p = 0.100). Compared with the control group, the transient cortical blindness group weighed less (p = 0.020), and had a larger dose of contrast agent (p = 0.034) and more instances of contrast agent injected into the posterior circulation (p < 0.001). Logistic regression analysis identified contrast agent dose and contrast agent injected into posterior circulation as independent predictive factors for transient cortical blindness (P < 0.05).Conclusion: Larger doses off contrast agent and contrast agent injected into the posterior circulation are potential independent predictive factors for transient cortical blindness following cerebral angiography.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Risk Factors of Transient Cortical Blindness After Cerebral Angiography: A Multicenter Study

Liang

Liu

et al. 2019

Front. Neurol.

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“…The diagnosis is challenging and might not be confirmed until complete recovery from vision loss. The underlying pathology remains unclear, but may be related to contrast agent neurotoxicity with transient disruption of BBB integrity [2,6].…”

Section: Resultsmentioning

confidence: 99%

“…As in TCB, typical MRI findings in PRES include high signal in FLAIR and DWI (diffusion weighted imaging) in parieto-occipital white matter and sometimes patchy contrast enhancement. Therefore, TCB has been suspected to be a result of PRES [6].…”

Section: Discussionmentioning

confidence: 99%

Transient Cortical Blindness: a Rare Complication After Cerebral Digital Subtraction Angiography

Weiss

Hollander

Pietsch

2019

SN Compr. Clin. Med.

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Transient cortical blindness (TCB) is a rare complication after cerebral or coronary angiography. In this article, we elaborate the condition and present a case which occurred in our hospital. With increasing numbers of diagnostic angiographies and endovascular interventions, we want to raise awareness of TCB and its clinical course. We report about a 57-year-old woman with TCB after a diagnostic digital subtraction angiography (DSA) and endovascular treatment of a ruptured aneurysm of the basilar tip. Symptoms disappeared spontaneously after 36 h with no residual deficits. Multimodal imaging including non-contrast enhanced cerebral CT-scan (NECT), cerebral magnetic resonance imaging (cMRI), and cerebral DSA are presented. Despite the seemingly grave event, the prognosis of this condition can be considered as excellent. The exact pathophysiology remains speculative, but might be related to contrast agent neurotoxicity with transient disruption of blood brain barrier integrity. Immediate computed tomographic angiogram (CTA) and CT-scan or magnetic resonance angiography (MRA) and cMRI should be performed after an occurrence of a suspected TCB to rule out embolic occlusions or hemorrhage. The administration of steroids can be considered.

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“…The mechanism may be a posterior reversible encephalopathy-like syndrome, but there is some evidence that the cause is a neurotoxic effect from contrast. 53 Resolution with time is the rule.…”

Section: Binocular Tvlmentioning

confidence: 99%

Update on the evaluation of transient vision loss

Pula¹,

Kwan²,

Yuen³

et al. 2016

OPTH

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Transient vision loss may indicate underlying vascular disease, including carotid occlusion and thromboembolism, or it may have a more benign etiology, such as migraine or vasospasm. This review focuses on the differential diagnosis and workup of patients presenting with transient vision loss, focusing on several key areas: the relationship to thromboembolic vascular disease, hypercoagulable testing, retinal migraine, and bilateral vision loss. The objective is to provide the ophthalmologist with information on how to best manage these patients. Thromboembolic etiologies for transient vision loss are sometimes managed with medications, but when carotid surgery is indicated, earlier intervention may prevent future stroke. This need for early treatment places the ophthalmologist in the important role of expediting the management process. Hospital admission is recommended in patients presenting with transient symptoms within 72 hours who meet certain high-risk criteria. When the cause is giant cell arteritis, ocular ischemic syndrome, or a cardioembolic source, early management of the underlying condition is equally important. For nonthromboembolic causes of transient vision loss such as retinal migraine or retinal vasospasm, the ophthalmologist can provide reassurance as well as potentially give medications to decrease the frequency of vision loss episodes.

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Transient Cortical Blindness Following Vertebral Angiography: A Case Report

Cited by 14 publications

References 8 publications

Risk Factors of Transient Cortical Blindness After Cerebral Angiography: A Multicenter Study

Risk Factors of Transient Cortical Blindness After Cerebral Angiography: A Multicenter Study

Transient Cortical Blindness: a Rare Complication After Cerebral Digital Subtraction Angiography

Update on the evaluation of transient vision loss

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