Cortical blindness due to osmotic disruption of the blood-brain barrier by angiographic contrast material: CT and MRI studies.
Numerous experimental studies have demonstrated disruption of the blood-brain barrier by the hyperosmolar, iodinated contrast agents in common use for intravascular injection during radiologic studies. We report 4 cases in which cortical blindness occurred after cerebral angiography. The patients underwent x-ray CT within 1 hour. CT showed abnormal contrast enhancement in the occipital regions in all 4 instances. Two patients underwent MRI; 1 of these manifested abnormal high-signal intensity in the occipital lobes on T2-weighted images. Only 2 previous cases documenting immediate contrast enhancement within the brain substance on CT following angiography are in the literature.
Lantos
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Department of Radiology, Albert Einstein College of Medicine, Bronx, NY.
D000368:Aged; D001766:Blindness / Q000139:chemically induced*; D001812:Blood-Brain Barrier / Q000187:drug effects*; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology*; D001933:Brain Stem / Q000000981:diagnostic imaging / Q000473:pathology; D003974:Diatrizoate Meglumine / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007482:Iothalamate Meglumine / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed
D003974:Diatrizoate Meglumine; D007482:Iothalamate Meglumine