Contrast-Induced Encephalopathy following Cerebral Angiography in a Hemodialysis Patient

Abstract

Contrast-induced encephalopathy (CIE) is a rare complication of contrast media use during angiographic procedures. With the growing use of endovascular interventions, this complication is likely to become more common. We present a case of a 46-year-old woman with hypertension, hypothyroidism, and chronic renal failure. She developed CIE following cerebral angiography for diagnosis of intracranial aneurysm. We had a high index of suspicion for CIE, excluded the most common differential such as stroke, and immediately started hemodialysis with a short course of corticosteroids. The disease runs a benign course, and neurological symptoms resolved completely after five days. We emphasize the need for increased awareness of CIE to make a valid diagnosis and to start supportive therapy as soon as possible.

Ratio of IL-8 in CSF Versus Serum Is Elevated in Patients with Unruptured Brain Aneurysm

“…At present, both primary diagnosis of IAs and follow up of those treated conservatively rely exclusively on their visualization. Nevertheless, the imaging either with MRI or with CT is hampered by high costs, limited availability, and a degree of biohazard related to irradiation and the use of a contrast agent [14]. Therefore, any method of screening for the IA's in population and/or for assessing the dynamics of aneurysm growth would be of paramount importance.…”

Contrast-enhanced encephalopathy and massive cerebral edema after endovascular coiling of cerebral aneurysm. A case report

“…Contrast-induced encephalopathy (CIEP) is a rare complication after endovascular therapy. [1][2][3][4][5] The precise etiological mechanisms via which this occur is still a matter of debate. 2,4 Nevertheless, osmotic disruption of the blood-brain barrier (BBB) arising from repeated contrast injections into a single vessel has been speculated as a cause of this complication.…”

“…2,4 Nevertheless, osmotic disruption of the blood-brain barrier (BBB) arising from repeated contrast injections into a single vessel has been speculated as a cause of this complication. 3,4,6 Chronic hypertension, transient ischemia attack, compromised cerebral autoregulation, renal failure, enormous contrast volumes, selective vertebralbasilar arteriography (VAG) and male gender have been implicated as predisposing factors of CIEP. 5,[7][8][9][10] The symptomatology of CIEP often commence during the procedure but become apparent few hours after the procedure.…”

“…5 Most symptoms are typically self-limiting, resolving within 2-4 days of onset. 3,11,12 Nevertheless, full recovery may take as long as few weeks in a few patients. 3,12 Anomalous cortical contrast enhancement with mild to severe edema, subarachnoid contrast enhancement, as well as striatal contrast enhancement are the typical postprocedural CT findings.…”

“…3,11,12 Nevertheless, full recovery may take as long as few weeks in a few patients. 3,12 Anomalous cortical contrast enhancement with mild to severe edema, subarachnoid contrast enhancement, as well as striatal contrast enhancement are the typical postprocedural CT findings. 2,9,12 Adequate hydration with intravenous crystalloids as well as anticonvulsants are the supportive treatment modalities for this post procedural complication.…”