Contrast-induced encephalopathy is a neurological complication related to contrast used in endovascular procedures or computed tomography (CT). The main risk factors are arterial hypertension, diabetes mellitus, chronic kidney disease (CKD), hyperosmolar contrasts, the amount of infused contrast and its direct infusion in the posterior cerebral territory, or pathologies with blood-brain barrier damage. Symptomatology is non-specific and may present as altered level of consciousness, neurological focality or seizures. Diagnosis is done by exclusion after ischemic or hemorrhagic stroke has been ruled out; CT or MRI are useful for differentiation. Generally, it appears shortly after exposure and the symptoms lasts 48-72h with complete recovery, although cases with persistence of symptoms or longer duration have been described. Treatment consists of monitoring, supportive measures and kidney replacement therapy (KRT) with hemodialysis (HD) in patients in chronic KRT program. It is important for the nephrologist to be aware of this entity given the susceptibility of the patient on HD as well as its potential therapeutic role in these patients.
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Contrast-induced encephalopathy with visual and auditory hallucinations triggered by coronary angiography with iodixanol: a case report.
Egypt Heart J
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Department of Interventional Cardiology and Internal Diseases, Military Institute of Medicine - National Research Institute, Zegrzyńska 8 Street, 05-119, Legionowo, Poland.
Article Synopsis
- Contrast-induced encephalopathy (CIE) is a rare but serious complication after coronary angiography, often presenting as transient cortical blindness; however, this case reports the first instance of CIE accompanied by visual and auditory hallucinations.
- An 80-year-old female patient experienced confusion and hallucinations following an elective coronary procedure, after complications were encountered during the angiography; stroke was initially suspected but ruled out through MRI.
- The patient was diagnosed with CIE and treated with sedation and quetiapine for her hallucinations, ultimately leading to the resolution of her symptoms within five days.
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Department of Neurosurgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
Objective: Contrast-induced encephalopathy (CIE) is a rare but severe complication that can occur following intravascular treatment of intracranial vascular disease. Although CIE is considered a transient neurological disorder, its natural history, pathophysiology, and risk factors are poorly understood. Contrast leakage (CL) is a more frequently observed adverse event than CIE and can lead to CIE.
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Contrast-induced encephalopathy (CIE) is a rare neurological complication that can occur following the use of contrast media during angiographic procedures. It can lead to neurological deficits, such as motor weakness. Transcranial motor-evoked potential (TcMEP) monitoring is commonly used to detect pyramidal tract disorders during embolization for intracranial aneurysms.
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