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冠状动脉造影术后造影剂诱发的脑病——病例报告

Contrast Medium-Induced Encephalopathy After Coronary Angiography- Case Report.

作者信息

Andone Sebastian, Balasa Rodica, Barcutean Laura, Bajko Zoltan, Ion Valentin, Motataianu Anca, Stoian Adina, Maier Smaranda

机构信息

Doctoral School, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Targu Mures Romania.

Department of Neurology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Targu Mures Romania.

出版信息

J Crit Care Med (Targu Mures). 2021 May 12;7(2):145-149. doi: 10.2478/jccm-2021-0010. eCollection 2021 Apr.

Abstract

INTRODUCTION

Contrast-induced encephalopathy represents a rare, reversible complication that appears after intravenous or intra-arterial exposure to contrast agents. There is no consensus in the literature regarding the mechanism of action. However, the theoretical mechanism is set around the disruption of the blood-brain barrier and the contrast agents' chemical properties.

CASE REPORT

The case of a 70-year-old patient, known to have hypertension and type 2 diabetes mellitus is reported. The patient had undergone a diagnostic coronary angiography during which he received 100ml of Ioversol (Optiray 350™). Soon after the procedure, the patient began experiencing a throbbing headache, followed by intense behavioural changes and aggressive tendencies. He was transferred to the Neurology Clinic. The neurological examination was without focal neurological signs; however, the patient was very aggressive and uncooperative. The CT scan revealed a mild hyper-density in the frontal lobes. MRI scan revealed no pathological changes. Conservative treatment with diuretics and hydration was administered, and the patient experienced a complete resolution of symptoms in 72 hours.

CONCLUSION

Contrast-induced encephalopathy is a possible secondary complication to contrast agents and a diagnostic challenge, and it should not be overlooked, especially following procedures that use contrast agents.

摘要

引言

造影剂诱发的脑病是一种罕见的、可逆转的并发症,出现在静脉或动脉注射造影剂之后。关于其作用机制,文献中尚无共识。然而,理论机制围绕血脑屏障的破坏和造影剂的化学性质展开。

病例报告

报告了一名70岁患者的病例,该患者患有高血压和2型糖尿病。患者接受了诊断性冠状动脉造影,在此过程中接受了100毫升碘海醇(欧乃派克350™)。术后不久,患者开始出现搏动性头痛,随后出现强烈的行为改变和攻击倾向。他被转到神经科诊所。神经系统检查未发现局灶性神经体征;然而,患者非常具有攻击性且不合作。CT扫描显示额叶有轻度高密度影。MRI扫描未发现病理变化。给予利尿剂和补液的保守治疗,患者在72小时内症状完全缓解。

结论

造影剂诱发的脑病是造影剂可能导致的继发性并发症,也是一项诊断挑战,不应被忽视,尤其是在使用造影剂的检查之后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02d1/8519365/c9b77cee4b46/jccm-07-145-g001.jpg

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