Transient oculomotor paralysis after cerebral angiography

Qiu, Tao; Dai, X.; Gong, Qingping; Pu, Rongmei; Xiao, Huang; Shi, Qiang; Deng, Xiaoyong; Guo, Zhaoyun

doi:10.1097/md.0000000000026242

Cited by 3 publications

(1 citation statement)

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“…It should be noted that not all CIE symptoms improve rapidly with treatment, particularly those related to nervous system damage, including visual disturbances, diplopia, and oculomotor dysfunction, which may be caused by optic and oculomotor nerve injury. Although most patients with CIE have a self-limited course and recover within 72 hours without sequelae, Qiu et al [19] reported a patient with CIE who required 19 days to recover after undergoing cerebral angiography. The case report by Leong et al [20] reported a patient who developed CIE after undergoing intracranial aneurysm coiling, and 1 year later, the patient still suffered from chronic left-sided limb spasticity and was diagnosed with irreversible CIE.…”

Section: Discussionmentioning

confidence: 99%

After 3 months of medication balloon therapy, a patient who had contrast-induced encephalopathy recovered: A case report

et al. 2023

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Rationale: Iodinated contrast agents are extensively employed in clinical settings, with allergic reactions and renal impairment being the most prevalent adverse events. Contrast-induced encephalopathy (CIE) can present with heterogeneous clinical features, making diagnosis challenging. Prior studies on CIE have primarily documented rapid recovery within several days. However, this paper describes a case of CIE in a patient whose clinical symptoms took 3 months to fully abate. Patient concerns: A female patient, aged 54 years, received drug-coated balloon therapy for stenosis in a branch of the anterior descending coronary artery. Unfortunately, the patient developed CIE, which initially manifested as visual disturbances and subsequently progressed to gastrointestinal and limb movement issues, as well as an altered mental status, all of which occurred within a 24-hour period during hospitalization. Diagnoses: The patient was diagnosed with CIE after cerebral hemorrhage, and cerebral edema was ruled out based on the history of contrast medium administration and radiographic exams. Interventions and outcomes: Dexamethasone (10 mg/d), mannitol (100 mL/d), betahistine (500 mL), trazodone (25 mg), and hydration supplementation were given to treat CIE-related symptoms. Aspirin and clopidogrel were administered for the management of the cardiovascular ailment. The neurologist prescribed neurotrophic agents, namely, cytarabine and methylcobalamin, based on the cerebral magnetic resonance imaging findings. Despite the treatment, the patient’s ocular symptoms, including blurry vision, diplopia, and impaired intraocular retraction, persisted. Furthermore, the patient’s mental state was altered, and she continued to exhibit a depressive state during her 1-month follow-up visit. Lessons: CIE is a comparatively infrequent ailment, and its prompt identification and management are of paramount importance. Although the treatments for CIE are primarily symptomatic, it is crucial to acknowledge that the symptoms may not always subside quickly within a short duration. In conjunction with pharmacotherapy, counseling should be offered to address patients’ mental health.

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Section: Discussionmentioning

confidence: 99%