Iatrogenically induced cortical blindness associated with leptomeningeal enhancement

• Published in: American journal of neuroradiology Vol. 19; no. 8; pp. 1522 - 1524
• Main Authors: Petrus, LV, Lois, JF, Lo, WW
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Oak Brook, IL Am Soc Neuroradiology 01-09-1998; American Society of Neuroradiology
• Subjects: Adult; AIDS/HIV; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Arachnoid - pathology; Biological and medical sciences; Blindness, Cortical - diagnosis; Blindness, Cortical - etiology; Blood-Brain Barrier - physiology; Brain - pathology; Case Reports; Catheters, Indwelling; Emergency and intensive care: metabolism and nutrition disorders. Enteral and parenteral nutrition; HIV Seropositivity - therapy; Humans; Iatrogenic Disease; Intensive care medicine; Magnetic Resonance Imaging; Male; Medical sciences; Meninges - pathology; Parenteral Nutrition, Total - instrumentation; Pia Mater - pathology; Tomography, X-Ray Computed; Vertebral Artery; Water-Electrolyte Balance - physiology; Human; Nervous system diseases; Cortical blindness; Catheterization; Vision disorder; Male; Increase; Contrast; Parenteral administration; Cerebral disorder; Feeding; Case study; Eye disease; Hyperosmolar solution; Central nervous system disease; Vertebral artery; Adult; Complication; Leptomeninge; Intraarterial administration; Diagnosis
• ISSN: 0195-6108; 1936-959X

Leptomeningeal enhancement is usually infective or neoplastic in origin. We present a case in which a patient received total parenteral nutrition via a catheter unknowingly placed within the right vertebral artery. We postulate that the hyperosmolar nature of the infused solution induced temporary osmotic disruption of the blood-brain barrier, resulting in cortical blindness associated with localized leptomeningeal enhancement.