scholarly journals Contrast-Induced Encephalopathy after Cerebral Angiogram: A Case Series and Review of Literature

2021 ◽  
pp. 405-413
Author(s):  
Cecelia Allison ◽  
Vaibhav Sharma ◽  
Jason Park ◽  
Clemens M. Schirmer ◽  
Ramin Zand

Contrast-induced encephalopathy (CIE) is a rare complication that arises from exposure to iodinated contrast medium and can result in a range of symptoms, including cortical blindness, aphasia, focal neurological deficits, and altered mental status. We present 4 individual cases of CIE who presented with stroke-mimic symptoms following surgery with localized iodixanol or ioversol injection. We outline a clinical timeline of all patients, showing that CIE follows a general pattern of delayed onset, worsening symptomology, and ultimately full recovery. All patients received IV hydration, corticosteroids, or both as part of their treatment protocol.

2012 ◽  
Vol 18 (1) ◽  
pp. 33-41 ◽  
Author(s):  
S. Leong ◽  
N.F. Fanning

Neurotoxicity from iodinated contrast agents is a known but rare complication of angiography and neurovascular intervention. Neurotoxicity results from contrast penetrating the blood-brain barrier with resultant cerebral oedema and altered neuronal excitability. Clinical effects include encephalopathy, seizures, cortical blindness and focal neurological deficits. Contrast induced encephalopathy is extensively reported as a transient and reversible phenomenon. We describe a patient with a persistent motor deficit due to an encephalopathy from iodinated contrast media administered during cerebral aneurysm coiling. This observation and a review of the literature highlights that contrast-induced encephalopathy may not always have a benign outcome and can cause permanent deficits. This potential harmful effect should be recognised by the angiographer and the interventionalist.


2018 ◽  
Vol 37 (01) ◽  
pp. 71-75
Author(s):  
Luana Antunes Maranha Gatto ◽  
Luana Bandeira Rocha ◽  
Gelson Koppe ◽  
Zeferino Demartini Jr

Background Coil migration after cerebral aneurysm embolization is a very rare complication. It can take place early or late in the postoperative period, evolving asymptomatic and causing severe neurological deficits. Ruptured aneurysms of anterior communicant artery were the most frequent reported examples in the literature. Case Report We report three cases of patients with unruptured aneurysms treated with coils and remodeling balloon technique. The first case was that of a left posterior communicating artery aneurysm with coil migration to a distal cortical branch of ipsilateral middle cerebral artery (MCA). The patient had mild paresthesia in the arm for a few days. The second one was a fenestrated basilar artery aneurysm with coil migration to the P2 segment of the left posterior cerebral artery. The patient was fully asymptomatic. The third case was a MCA aneurysm with coil migration to the M3 segment. There were no ischemic complications, and all patients underwent a new endovascular procedure. Conclusions Coil migration is a rare but not always severe complication. Antiplatelet agents are recommended even if the coil migration is asymptomatic.


2020 ◽  
pp. 1-4

Abstract Neurotoxicity from contrast media used in angiography is a rare complication from these procedures caused by disruption of the blood–brain-barrier (BBB), most of the time presenting as cortical blindness. The infrequency with which it is encountered makes it a diagnostic challenge. We present the case of a 64-year-old male who developed right hemianopsia, prosopagnosia and hallucinations after embolization of a cervical spinal dural arteriovenous fistula. The neurological deficits which appeared after the procedure, regressed completely after 48 hours. This rare entity should be kept in mind but diagnosed only when all other causes have been ruled out.


Cardiology ◽  
2018 ◽  
Vol 139 (3) ◽  
pp. 197-201 ◽  
Author(s):  
Abhishek Dattani ◽  
Laura Au ◽  
Kok Hoon Tay ◽  
Patrick Davey

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.


HPB ◽  
2019 ◽  
Vol 21 ◽  
pp. S542
Author(s):  
A.M. Schreuder ◽  
T.M. van Gulik ◽  
E.A. Rauws

Author(s):  
Chandramouli M.T

AbstractLife-threatening adverse reactions of antitubercular drugs are uncommon; however, thrombocytopenia is one such rare complication encountered with rifampicin, isoniazid, ethambutol, and pyrazinamide. Rifampicin is the most effective drug and its use in the tuberculosis treatment led to the emergence of modern and effective short-course regimens. I am reporting case series of three patients with pulmonary tuberculosis presented with rifampicin-induced thrombocytopenia.


2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
E Lau ◽  
Z Arshad ◽  
A Aslam ◽  
A Thahir ◽  
M Krkovic

Abstract Introduction Osteomyelitis refers to an inflammatory process affecting bone and bone marrow. This study reviews chronic femoral osteomyelitis treatment and outcomes, including economic impact. Method We retrospectively collected data from a consecutive series of 14 chronic femoral osteomyelitis patients treated between January 2013 and January 2020. Data collected include patient demographics, comorbidities, pathogens, complications, treatment protocol and costs. Functional outcome was assessed using EuroQOL five-dimensional interview administration questionnaire (EQ-5D-5L™) and EuroQOL Visual Analogue Scale (EQ-VAS™). Results Of these, 92.9% had one or more osteomyelitis risk factor, including smoking and diabetes. Samples from 78.6% grew at least one pathogen. Only 42.9% achieved remission after initial treatment, but 85.7% were in remission at final follow-up, with no signs of recurrence throughout the follow-up period (mean: 21.4 months). The average treatment cost was £39,249.50 with a net mean loss of £19,080.10 when funding was considered. The mean-derived EQ-5D score was 0.360 and the mean EQ-VAS score was 61.7, lower than their values for United Kingdom’s general population, p = 0.0018 and p = 0.013 respectively. Conclusions Chronic femoral osteomyelitis treatment is difficult, resulting in significant economic burden. With previous studies showing cheaper osteomyelitis treatment at specialist centres, our net financial loss incurred suggests the need for management at specialised centres.


Author(s):  
Biyan Nathanael Harapan ◽  
Hyeon Joo Yoo

AbstractSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus, is responsible for the outbreak of coronavirus disease 19 (COVID-19) and was first identified in Wuhan, China in December 2019. It is evident that the COVID-19 pandemic has become a challenging world issue. Although most COVID-19 patients primarily develop respiratory symptoms, an increasing number of neurological symptoms and manifestations associated with COVID-19 have been observed. In this narrative review, we elaborate on proposed neurotropic mechanisms and various neurological symptoms, manifestations, and complications of COVID-19 reported in the present literature. For this purpose, a review of all current published literature (studies, case reports, case series, reviews, editorials, and other articles) was conducted and neurological sequelae of COVID-19 were summarized. Essential and common neurological symptoms including gustatory and olfactory dysfunctions, myalgia, headache, altered mental status, confusion, delirium, and dizziness are presented separately in sections. Moreover, neurological manifestations and complications that are of great concern such as stroke, cerebral (sinus) venous thrombosis, seizures, meningoencephalitis, Guillain–Barré syndrome, Miller Fisher syndrome, acute myelitis, and posterior reversible encephalopathy syndrome (PRES) are also addressed systematically. Future studies that examine the impact of neurological symptoms and manifestations on the course of the disease are needed to further clarify and assess the link between neurological complications and the clinical outcome of patients with COVID-19. To limit long-term consequences, it is crucial that healthcare professionals can early detect possible neurological symptoms and are well versed in the increasingly common neurological manifestations and complications of COVID-19.


2020 ◽  
Vol 58 (04) ◽  
pp. 352-356
Author(s):  
Tobias Kukiolka ◽  
Jan Borovicka ◽  
Stephan Baumeler ◽  
Marc Schiesser ◽  
Christoph Gubler

AbstractBouveret’s syndrome is a rare complication resulting from gallstone disease. Both surgical and endoscopical procedures are performed, with the disease to be seen as strictly interdisciplinary. There are no well-established recommendations for this condition. In this paper, we want to describe our experience from 6 cases in 3 Swiss hospitals from 2015 to 2017 with emphasis on the endoscopic technique of electrohydraulic lithotripsy followed by balloon dilatation and propose a treatment algorithm.


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