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脑血管异常患者经皮冠状动脉介入治疗后发生的罕见对比剂诱发的脑病:一例报告。

An unusual contrast-induced encephalopathy following percutaneous coronary intervention in patients with cerebrovascular abnormalities: A case report.

作者信息

Liao Jiangquan, Wang Yan, Shao Mingjing, Wang Yanling, Du Jinhang, Li Xianlun, Yang Peng, Fu Dongliang, Dong Zhe, Liu Mengru

机构信息

National Integrated Traditional and Western Medicine Center for Cardiovascular Disease, China-Japan Friendship Hospital, Beijing, China.

Department of Cardiovascular and Respiratory Medicine, Beijing Nuclear Industry Hospital, Beijing, China.

出版信息

Front Cardiovasc Med. 2022 Nov 24;9:957779. doi: 10.3389/fcvm.2022.957779. eCollection 2022.

Abstract

INTRODUCTION

Contrast-induced encephalopathy (CIE) is a complication associated with the administration of iodinated contrast, which usually happens minutes to hours after contact with contrast, and fully recovers within 72 h. The clinical manifestations of CIE are diverse, and the pathological mechanism is not explicit.

METHODS

We report the case of a 66-year-old female who suffered from a delayed CIE following the administration of iodinated contrast agent. Symptoms were severe. Imaging examination, biochemical and etiological detection were performed timely. The course of neurological symptoms was atypical. Her complex complications of hypothyroidism and cerebrovascular abnormalities contributed to more challenges, which were also clues to the diagnosis. With prompt and active treatment, the patient recovered fully over 10 days.

DISCUSSION

The diagnosis standard of CIE highly depends on the association with the contact of contrast and the exclusion of other nervous system diseases. Complicated clinical circumstances and individual specificity can lead to different clinical manifestations of CIE, making it even more difficult to diagnose and treat. Prompt and dynamic imaging examination would provide great value in the diagnosis and evaluation of CIE. Timely diagnosis and intervention may be the key to its satisfying prognosis.

摘要

引言

对比剂所致脑病(CIE)是一种与碘化对比剂使用相关的并发症,通常在接触对比剂后数分钟至数小时内发生,并在72小时内完全恢复。CIE的临床表现多样,病理机制尚不明确。

方法

我们报告了一例66岁女性在使用碘化对比剂后发生迟发性CIE的病例。症状严重。及时进行了影像学检查、生化及病因学检测。神经症状过程不典型。她的甲状腺功能减退和脑血管异常等复杂并发症带来了更多挑战,这些也是诊断的线索。经过及时积极的治疗,患者在10天内完全康复。

讨论

CIE的诊断标准高度依赖于与对比剂接触的相关性以及排除其他神经系统疾病。复杂的临床情况和个体特异性可导致CIE出现不同的临床表现,使其诊断和治疗更加困难。及时动态的影像学检查对CIE的诊断和评估具有重要价值。及时诊断和干预可能是其良好预后的关键。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4615/9729246/c9173c03d03e/fcvm-09-957779-g001.jpg

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