Transient contrast encephalopathy after carotid artery stenting mimicking diffuse subarachnoid hemorrhage: a case report.
Several types of brain injury incurred during carotid artery stenting (CAS), such as embolic injury, hemodynamic events, and hemorrhage. Rapid differential diagnosis is important for decision making, and may help to avoid subsequent complications. Here, we describe a case with severe triple vessel coronary artery disease, who underwent right coronary artery (RCA) stenting and ad hoc left CAS. Patient developed neurological deficit two hours after the procedure. Brain computed tomography (CT) revealed diffuse cortical enhancement similar to subarachnoid hemorrhage (SAH). Patient recovered dramatically with complete resolution of contrast enhancement after four days of conservative treatment, final diagnosis was a rare reported case of transient contrast encephalopathy.
Fang
Hsiu-Yu
HY
Division of Cardiology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Kuo
Yeh-Lin
YL
Wu
Chiung-Jen
CJ
D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000295:instrumentation*; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging; D006801:Humans; D008297:Male; D020258:Neurotoxicity Syndromes / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D015641:Radiography, Interventional; D012075:Remission, Spontaneous; D015607:Stents; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed
D003287:Contrast Media