一例造影剂诱发的脑病。
A case of contrast-induced encephalopathy.
作者信息
Neilan Patrick, Urbine Daniel
机构信息
Department of Internal Medicine, UF Health Shands, Gainesville, Florida, USA.
Department of Internal Medicine, University of Florida, Gainesville, Florida, USA.
出版信息
BMJ Case Rep. 2019 Dec 1;12(11):e229717. doi: 10.1136/bcr-2019-229717.
Abstract
The differential diagnosis of the patient with encephalopathy is broad and remains a common yet challenging problem for critical care physicians. A case is presented of contrast-induced encephalopathy in an 81-year-old man undergoing a left heart catheterisation after receiving iopamidol, a low-osmolar contrast agent. Immediately after receiving contrast, our patient experienced severe headache, agitation, altered mentation and significant skin hypersensitivity. This rare, acute and reversible neurological disturbance can be associated with administration of intra-arterial, osmotic, iodinated contrast. Although uncommon, it is important to recognise the various presentations, risk factors and treatment of this condition.
摘要
脑病患者的鉴别诊断范围广泛，对于重症监护医生来说仍然是一个常见但具有挑战性的问题。本文介绍了一例81岁男性在接受低渗性造影剂碘帕醇后进行左心导管插入术时发生的造影剂诱导性脑病病例。在接受造影剂后，我们的患者立即出现严重头痛、烦躁不安、精神状态改变和明显的皮肤过敏反应。这种罕见、急性且可逆的神经功能障碍可能与动脉内注射渗透性碘化造影剂有关。尽管不常见，但认识到这种疾病的各种表现、危险因素和治疗方法很重要。
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本文引用的文献
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Asian J Neurosurg. 2018 Oct-Dec;13(4):1254-1256. doi: 10.4103/ajns.AJNS_188_17.
2
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Case Rep Med. 2018 Mar 4;2018:9278526. doi: 10.1155/2018/9278526. eCollection 2018.
3
Contrast-Induced Encephalopathy following Coronary Angiography with No Radiological Features: A Case Report and Literature Review.冠状动脉造影后无放射学特征的对比剂诱发脑病：一例报告及文献综述
Cardiology. 2018;139(3):197-201. doi: 10.1159/000486636. Epub 2018 Feb 2.
4
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J Cerebrovasc Endovasc Neurosurg. 2017 Sep;19(3):184-188. doi: 10.7461/jcen.2017.19.3.184. Epub 2017 Sep 30.
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