Persistent Neurological Deficit from Iodinated Contrast Encephalopathy following Intracranial Aneurysm Coiling A Case Report and Review of the Literature

• Published in: Interventional neuroradiology Vol. 18; no. 1; pp. 33 - 41
• Main Authors: Leong, S., Fanning, N.F.
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01-03-2012; Centauro S.r.l
• Subjects: Cerebral Angiography - adverse effects; Contrast Media - adverse effects; Embolization, Therapeutic; Female; Humans; Intracranial Aneurysm - diagnostic imaging; Intracranial Aneurysm - therapy; Iodine Radioisotopes - adverse effects; Middle Aged; Neurotoxicity Syndromes - etiology; Original; Tomography, X-Ray Computed - adverse effects; interventional neuroradiology; neurotoxicity; deficit; coiling; contrast
• ISSN: 1591-0199; 2385-2011
• DOI: 10.1177/159101991201800105

Neurotoxicity from iodinated contrast agents is a known but rare complication of angiography and neurovascular intervention. Neurotoxicity results from contrast penetrating the blood-brain barrier with resultant cerebral oedema and altered neuronal excitability. Clinical effects include encephalopathy, seizures, cortical blindness and focal neurological deficits. Contrast induced encephalopathy is extensively reported as a transient and reversible phenomenon. We describe a patient with a persistent motor deficit due to an encephalopathy from iodinated contrast media administered during cerebral aneurysm coiling. This observation and a review of the literature highlights that contrast-induced encephalopathy may not always have a benign outcome and can cause permanent deficits. This potential harmful effect should be recognised by the angiographer and the interventionalist.