Cortical blindness after coronary angiography: A rare but reversible complication

Kinn, Robert M; Breisblatt, Warren M.

doi:10.1002/ccd.1810220305

Cited by 51 publications

(40 citation statements)

References 10 publications

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“…1,8,10,[14][15][16]19) The incidence of transient cortical blindness is as high as 1% with cerebral angiography. 5,17) However, the recent introduction of non-ionic contrast materials is considered to have significantly reduced the risk, and this complication has become extremely rare.…”

Section: Discussionmentioning

confidence: 99%

Cortical Blindness During Coil Embolization of an Unruptured Intracranial Aneurysm-Case Report-

Shinoda

Ajimi

Yamada

et al. 2004

Neurol. Med. Chir.(Tokyo)

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A 62-year-old woman suffered transient cortical blindness during coil embolization for a saccular aneurysm in the posterior circulation, with cerebral angiography using non-ionic contrast material. Just before completion of the procedure, the patient showed abrupt onset of restlessness and blindness. At this point 150 ml of contrast material had been injected into the left vertebral artery. Immediate computed tomography showed persistence of contrast medium in the bilateral occipital lobes and part of the left frontal lobe. Repeat angiography showed no evidence of embolism. Single photon emission computed tomography obtained the next day showed decreased perfusion in the bilateral occipital lobes. Magnetic resonance imaging on the third day showed multiple lesions in the bilateral occipital lobes. Her vision was restored gradually. Transient cortical blindness may be associated with osmotic disruption of the blood-brain barrier in the bilateral occipital lobes. Endovascular neurosurgeons must be aware of this rare complication.

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Section: Discussionmentioning

confidence: 99%

Cortical Blindness During Coil Embolization of an Unruptured Intracranial Aneurysm-Case Report-

Shinoda

Ajimi

Yamada

et al. 2004

Neurol. Med. Chir.(Tokyo)

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“…Table 1 summarises the published CIE cases following cardiac catheterisation with normal head CT findings from 1970 to the present day. To date there have been 16 cases [1-11]. …”

Section: Discussionmentioning

confidence: 99%

“…In most cases of CIE, the prognosis has been excellent, with rapid recovery with supportive management only, usually by use of intravenous hydration and close observation of the patient [1-11], which is recommended in the immediate postprocedural period. In a few cases, anticonvulsants have been used to treat seizures [7, 14, 15] and steroids used to reduce cerebral oedema with no adverse consequences [13].…”

Section: Discussionmentioning

confidence: 99%

Contrast-Induced Encephalopathy following Coronary Angiography with No Radiological Features: A Case Report and Literature Review

Dattani

Tay

et al. 2018

Cardiology

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Contrast-induced encephalopathy (CIE) following coronary angiography (CAG) is a very rare complication. Radiological signs such as cerebral oedema and cortical enhancement are of great importance in the diagnosis. We report a case of probable CIE in a 76-year-old gentleman following a normal diagnostic CAG that involved 120 mL of the iodinated contrast agent iohexol (Omnipaque 300). At 90 min postprocedure he became acutely confused with a normal non-contrast CT of the head. After 9 days of conservative treatment, the patient recovered spontaneously with no neurological deficits. This case and a review of the literature highlights that contrast-induced neurotoxicity may not always present with the typical radiological signs that are described in association with CIE. Given the excellent prognosis with supportive management only, interventional cardiologists should be well aware of this condition despite the absence of radiological features.

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“…Fischer-Williams et al reported one case in 12,367 coronary angiographies, an incidence of 0.008% [3] and Kinn et al reported three cases in over 6,000 such procedures, an incidence of 0.05% [4].…”

Section: Introductionmentioning

confidence: 99%

A Case of Transient Loss of Vision Following Coronary Angiography: Etiology, Investigation and Management

et al. 2016

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Cortical blindness is, thankfully, a rarely encountered complication of coronary angiography. We present the case of a 72-year-old Caucasian gentleman in whom bilateral visual loss occurred abruptly after exposure to contrast during diagnostic coronary angiography. Areas of acute cerebral infarction were not appreciated at initial cranial computed tomography. Leakage of contrast medium into the occipital cortices was similarly absent. The patient recovered vision within 24 hours. Given the frequency with which coronary angiography is performed worldwide, an awareness of the causes of cortical blindness following the same is important. Although already well elaborated in the literature related to both cardiology and radiology, there are few reports in the general medical or ophthalmology literature that describe transient cortical blindness after coronary angiography and detail contrast-associated visual loss.

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Cortical blindness after coronary angiography: A rare but reversible complication

Cited by 51 publications

References 10 publications

Cortical Blindness During Coil Embolization of an Unruptured Intracranial Aneurysm-Case Report-

Cortical Blindness During Coil Embolization of an Unruptured Intracranial Aneurysm-Case Report-

Contrast-Induced Encephalopathy following Coronary Angiography with No Radiological Features: A Case Report and Literature Review

A Case of Transient Loss of Vision Following Coronary Angiography: Etiology, Investigation and Management

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