Iatrogenically induced cortical blindness associated with leptomeningeal enhancement.
Leptomeningeal enhancement is usually infective or neoplastic in origin. We present a case in which a patient received total parenteral nutrition via a catheter unknowingly placed within the right vertebral artery. We postulate that the hyperosmolar nature of the infused solution induced temporary osmotic disruption of the blood-brain barrier, resulting in cortical blindness associated with localized leptomeningeal enhancement.
Petrus
L V
LV
Department of Radiological Sciences, Olive View-UCLA Medical Center, Sylmar, CA 91342, USA.
Lois
J F
JF
Lo
W W
WW
D000328:Adult; D001099:Arachnoid / Q000473:pathology; D019575:Blindness, Cortical / Q000175:diagnosis* / Q000209:etiology; D001812:Blood-Brain Barrier / Q000502:physiology; D001921:Brain / Q000473:pathology; D002408:Catheters, Indwelling; D006679:HIV Seropositivity / Q000628:therapy; D006801:Humans; D007049:Iatrogenic Disease; D008279:Magnetic Resonance Imaging; D008297:Male; D008578:Meninges / Q000473:pathology*; D010289:Parenteral Nutrition, Total / Q000295:instrumentation; D010841:Pia Mater / Q000473:pathology; D014057:Tomography, X-Ray Computed; D014711:Vertebral Artery; D014882:Water-Electrolyte Balance / Q000502:physiology