Transient global amnesia after cerebral angiography with iohexol

Abstract

We describe a patient without a previous history of migraine or epilepsy and with no known vascular risk factors, who suffered subarachnoid haemorrhage. During vertebral angiography using nonionic contrast medium (iohexol), spasm of the basilar artery was seen. The patient suffered transient global amnesia. Angiography 3 months later with the same contrast medium was normal and produced no further deficit. This case lends support to the supposed ischaemic aetiology of transient global amnesia; in patients without other evidence of cerebrovascular disease, arterial spasm may be responsible.

Transient Global Amnesia, Migraine, Thalamic Infarct, Dihydroergotamine, and Sumatriptan

“…Transient global amnesia classically occurs after cerebral or coronary angiography, even when the findings are normal, suggesting a role for vasospasm. Juni et al 17 even visualized spasm of the basilar artery and concomitant onset of TGA during vertebral angiography. In the patient described here, repeat angiography, 3 months later, was normal, and an ischemic lesion in the thalamus was demonstrated on MRI.…”

An experimental study on multi-slices CT angiography of the basilar artery in rabbit model of cerebral vasospasm

“…Therefore, different types of contrast agents do not cause or aggravate cerebral vasospasm. However, Juni et al [21] held that some patients would result in CVS during brain angiography by using Onipaque. Minuk et al [22] agreed with that contrast agents would make endothelial cells shrink, then change the stability of blood-brain barrier and tight junctions of endothelial cell.…”

“…Unlike the result of Luo zhiyi's experiment [20], intravascular injection of contrast agent could lead to CVS in our research. To Juni [21] and Minuk [22] description, CVS resulted from intravascular injection of non-ionic contrast agents. Whether the studies have certain comparable and correlation remains to be seen.…”

Transient global amnesia after cerebral angiography still occurs: Case report and literature review

“…A formal PubMed literature search including (but not limited to) the following terms–“transient global amnesia,” “TGA,” ”amnesic syndrome,” “digital subtraction angiography,” and “cerebral angiography” in various combinations–uncovered only 15 case-report observations of isolated TGA following diagnostic cerebral angiography with nonionic contrast agent ( 9 , 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ) (see Table ), the last of which was published in 1997 ( 9 ). A prospective analysis of 2,899 cerebral angiographies using nonionic contrast agents has shown a TGA complication rate of 0.002% ( 18 ), thus establishing TGA as a very rare and possibly underdiagnosed complication of cerebral angiography.…”