Vigano' Martina, Mantero Vittorio, Basilico Paola, Cordano Christian, Sangalli Davide, Reganati Paolo, Lunghi Alessandro, Rigamonti Andrea, Salmaggi Andrea
Neurological Department, "A. Manzoni" Hospital, ASST Lecco, Via dell'Eremo 9/11, 23900, Lecco, Italy.
UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA.
Neurol Sci. 2021 Mar;42(3):1145-1150. doi: 10.1007/s10072-020-04844-1. Epub 2020 Oct 22.
Contrast-induced encephalopathy is a rare and usually reversible entity due to the administration of iodinated contrast. Clinical manifestations include cortical blindness, encephalopathy, seizures and focal neurological deficits.
We report the case of a 56-year-old woman who developed global aphasia and right hemiplegia after a cerebral angiography performed for a subarachnoid haemorrhage. A prompt brain MRI resulted negative, while CT scan revealed left cerebral oedema with the cerebral sulci effacement. Complete recovery was observed in 10 days.
Diagnosis of contrast-induced encephalopathy requires a temporal correlation between neurological dysfunction and administration of iodinated contrast. Usually, the symptomatology is transient with a full recovery within 48-72 h. The most common symptom is cortical blindness, while other symptoms have been rarely reported. Only 20 cases previously reported global aphasia and/or hemiplegia or mimed anterior circulation strokes. Prompt brain neuroimaging is essential in order to exclude an alternative diagnosis that requires a distinct therapeutic approach.
造影剂诱发的脑病是一种罕见的、通常可逆转的病症，由使用含碘造影剂引起。临床表现包括皮质盲、脑病、癫痫发作和局灶性神经功能缺损。
我们报告了一名56岁女性的病例，该患者在因蛛网膜下腔出血进行脑血管造影后出现完全性失语和右侧偏瘫。脑部MRI检查结果迅速显示为阴性，而CT扫描显示左侧脑水肿伴脑沟消失。10天后观察到完全康复。
造影剂诱发的脑病的诊断需要神经功能障碍与使用含碘造影剂之间存在时间相关性。通常，症状是短暂的，48 - 72小时内可完全恢复。最常见的症状是皮质盲，而其他症状鲜有报道。此前仅有20例报告出现完全性失语和/或偏瘫或类似前循环卒中的症状。及时进行脑部神经影像学检查对于排除需要不同治疗方法的其他诊断至关重要。
