Patel Aakaash, Zolyan Anna, Itrat Ahmed
Department of Neurology, Northeast Ohio Medical University, Rootstown, USA.
Neurology, University of California Irvine Medical Center, Orange, USA.
Cureus. 2021 Mar 24;13(3):e14084. doi: 10.7759/cureus.14084.
Gadolinium contrast administration, usually with magnetic resonance imaging, is an important diagnostic modality in the investigation of neurological pathologies. There is little evidence in the literature suggesting repeated exposure to intrathecal gadolinium results in symptoms mimicking post-concussive syndrome (PCS). We studied one patient who received intrathecal gadolinium to investigate a pain pump malfunction and presented with encephalopathic symptoms of confusion and aphasia with imaging consistent with intracranial gadolinium extravasation. The patient was followed up regularly with repeat imaging, reassessment of persistent symptoms, and specialist evaluations; however, symptoms remained refractory and resembled PCS. Our findings indicate a need to further investigate potential associations between intrathecal gadolinium exposure and a clinical presentation consistent with PCS, irrespective of histopathological changes.
钆造影剂给药，通常用于磁共振成像，是神经病理学研究中的一种重要诊断方式。文献中几乎没有证据表明反复鞘内注射钆会导致类似脑震荡后综合征（PCS）的症状。我们研究了一名接受鞘内注射钆以调查疼痛泵故障的患者，该患者出现了意识模糊和失语的脑病症状，影像学检查显示符合颅内钆外渗。对该患者进行了定期随访，包括重复成像、对持续症状的重新评估以及专科评估；然而，症状仍然难以缓解，且类似于PCS。我们的研究结果表明，需要进一步调查鞘内注射钆暴露与符合PCS的临床表现之间的潜在关联，无论组织病理学变化如何。
