Iwata Tomonori, Mori Takahisa, Tajiri Hiroyuki, Miyazaki Yuichi, Nakazaki Masahito
Department of Stroke Treatment, Shonan Kamakura General Hospital Stroke Center, Kamakura, Kanagawa, Japan.
Neurol Med Chir (Tokyo). 2013;53(1):34-6. doi: 10.2176/nmc.53.34.
An early 60s-year-old man suffered reversible dysfunction of the blood-brain barrier (BBB) induced by repeated injection of contrast medium during coil embolization of intracranial unruptured aneurysm. He presented with convulsion during coil embolization, and neurological symptoms of aphasia and right hemiparesis continued for 5 days, and then improved completely. All transient radiological abnormalities were limited to the territory of the left internal carotid artery, where contrast medium was injected repeatedly. Repeated computed tomography, magnetic resonance imaging, single-photon emission computed tomography, and cerebrospinal fluid test findings indicated that temporary dysfunction of the BBB might have occurred. Dysfunction of the BBB in the anterior circulation induced by contrast medium is rare. Tolerance to toxicity of contrast medium may depend on the individual patient, and repeated injection of contrast medium may cause dysfunction of the BBB, leading to toxic dysfunction directly in the brain.
一名60岁出头的男性在颅内未破裂动脉瘤的弹簧圈栓塞过程中，因反复注射造影剂而出现了血脑屏障（BBB）的可逆性功能障碍。他在弹簧圈栓塞过程中出现惊厥，失语和右侧偏瘫的神经症状持续了5天，随后完全好转。所有短暂的放射学异常均局限于反复注射造影剂的左颈内动脉供血区域。重复的计算机断层扫描、磁共振成像、单光子发射计算机断层扫描和脑脊液检查结果表明，可能发生了血脑屏障的暂时性功能障碍。造影剂引起的前循环血脑屏障功能障碍很少见。对造影剂毒性的耐受性可能因个体患者而异，反复注射造影剂可能导致血脑屏障功能障碍，直接导致脑部毒性功能障碍。
