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颈动脉支架置入术后酷似弥漫性蛛网膜下腔出血的短暂性对比剂脑病:一例报告

Transient contrast encephalopathy after carotid artery stenting mimicking diffuse subarachnoid hemorrhage: a case report.

作者信息

Fang Hsiu-Yu, Kuo Yeh-Lin, Wu Chiung-Jen

机构信息

Division of Cardiology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.

出版信息

Catheter Cardiovasc Interv. 2009 Jan 1;73(1):123-6. doi: 10.1002/ccd.21779.

Abstract

Several types of brain injury incurred during carotid artery stenting (CAS), such as embolic injury, hemodynamic events, and hemorrhage. Rapid differential diagnosis is important for decision making, and may help to avoid subsequent complications. Here, we describe a case with severe triple vessel coronary artery disease, who underwent right coronary artery (RCA) stenting and ad hoc left CAS. Patient developed neurological deficit two hours after the procedure. Brain computed tomography (CT) revealed diffuse cortical enhancement similar to subarachnoid hemorrhage (SAH). Patient recovered dramatically with complete resolution of contrast enhancement after four days of conservative treatment, final diagnosis was a rare reported case of transient contrast encephalopathy.

摘要

颈动脉支架置入术(CAS)期间会发生几种类型的脑损伤,如栓塞性损伤、血流动力学事件和出血。快速鉴别诊断对于决策很重要,可能有助于避免后续并发症。在此,我们描述一例患有严重三支血管冠状动脉疾病的患者,该患者接受了右冠状动脉(RCA)支架置入术和临时左颈动脉支架置入术。术后两小时患者出现神经功能缺损。脑部计算机断层扫描(CT)显示弥漫性皮质强化,类似于蛛网膜下腔出血(SAH)。经过四天的保守治疗,患者造影剂增强完全消退,恢复显著,最终诊断为罕见的短暂性造影剂脑病病例。

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