[Cerebral contrast medium extravasation after coronary angioplasty].
We report on an 82-year-old woman who suffered a sudden loss of consciousness, right-sided hemiparesis, and aphasia during a coronary angiographic procedure. Computed tomography (CT) of the brain performed immediately revealed an edema and extravascularly localized contrast media in the left hemisphere. Within 6 h, neurological symptoms had disappeared, and a second CT after 48 h revealed normal results. Usually, extravasation of contrast media affects the posterior circulation with cortical blindness. This case demonstrates that contrast media may affect the blood-brain barrier also outside the posterior circulation. If neurological symptoms occur during angiography, contrast media extravasation must be distinguished from embolism or vasospasm induced by the angiographic procedure.
Foltys
H
H
Abteilung für Neurologie, Universitätsklinik Aachen. hfoltys@gmx.de
Krings
T
T
Block
F
F
D000368:Aged; D000369:Aged, 80 and over; D001037:Aphasia / Q000139:chemically induced / Q000000981:diagnostic imaging; D001812:Blood-Brain Barrier / Q000187:drug effects*; D001929:Brain Edema / Q000139:chemically induced* / Q000000981:diagnostic imaging; D003287:Contrast Media / Q000009:adverse effects* / Q000493:pharmacokinetics; D017023:Coronary Angiography / Q000009:adverse effects*; D004292:Dominance, Cerebral / Q000187:drug effects; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000000981:diagnostic imaging*; D005260:Female; D006429:Hemiplegia / Q000139:chemically induced / Q000000981:diagnostic imaging; D006801:Humans; D007472:Iohexol / Q000009:adverse effects* / Q000031:analogs & derivatives* / Q000493:pharmacokinetics; D008657:Metabolic Clearance Rate / Q000502:physiology; D009460:Neurologic Examination / Q000187:drug effects; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D007472:Iohexol; C038192:iopromide