13 November 2020: Articles
Contrast-Induced Transient Neurological Symptoms Following Percutaneous Coronary Intervention: A Case Report
Challenging differential diagnosis, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents, Unexpected drug reaction, Rare disease, Clinical situation which can not be reproduced for ethical reasons
Aishah Albakr A* , Noman Ishaque E , Danah Aljaafari F , Sabah N. Sairafi EDOI: 10.12659/AJCR.926956
Am J Case Rep 2020; 21:e926956
Table 1. Case reports of patients who have undergone PCI and developed focal neurological symptoms.
| Study | Age/sex | Risk factors | Type and dose of the contrast | Neurological findings | The onset of the neurological symptoms after PCI | Neuroimaging findings | Treatment | Outcome |
|---|---|---|---|---|---|---|---|---|
| Law S, et al. (2012) []12 | 69y/F | HTN, DM, impaired renal function | Iodixanol, 320 mgI/mL | Seizures, left-sided weakness, homonymous hemianopia, hemisensory loss, and hemineglect | 12 h | Initial CT: frontal and parietal lobes edema | Intravenous thrombolysis | Complete recovery within 24 h. Complete resolution on follow up, 32-h MRI and 84-h CT |
| Heemlar JC, et al. (2018) []13 | 67 y/F | HTN/DM | Iodixanol, 100 ml | Altered level of consciousness, right-sided hypertonia and bilateral upgoing plantar | 0–4 h | CT: right-sided hypodensities in the watershed regions. Repeated scan at 4h showed diffuse bilateral cerebral edema | Intubation, dexamethasone, and levetiracetam | 4 days: marked improvement. 3 weeks: complete resolution of the radiological findings on MRI. 6 weeks follow up: complete neurological recovery |
| Raju NS, et al. (2015) []14 | 44 y/F | HTN/DM/ ESRD on peritoneal dialysis | Iohexol (Omnipaque 350), 190 mL | Headache, seizure, and left-sided weakness | A few hours | CT: contrast retention in the right cerebral hemisphere and left cerebral hemisphere watershed territories | Lorazepam and levetiracetam for seizures, peritoneal dialysis | Complete recovery within 3 days |
| Yıldız A, et al. (2003) []15 | 63 y/M | NA | Iomeprol (imeron), 450 ml | Amnesia, headache and right upper extremity numbness | NA | CT: contrast retention at the right frontal, occipital, and parietal lobes | Dexamethasone | Complete neurological and radiological recovery within 25 h |
| Velden J, et al. (2003) []16 | 82 y/F | HTN, impaired renal function | Iomeprol (imeron), 500 ml | Altered LOC, Malignant HTN, aphasia, and right-side hemiparesis | 6 h | CT: contrast retention the sulci of both brain hemispheres | Close observation, supportive care | Complete recovery at 40 h |