تقرير
Acute-onset coma after iso-osmolar iodinated contrast injection: a case report of contrast-induced encephalopathy after elective coronary angiography.
| العنوان: | Acute-onset coma after iso-osmolar iodinated contrast injection: a case report of contrast-induced encephalopathy after elective coronary angiography. |
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| المؤلفون: | Heemelaar JC; Department of Cardiology, VU University Medical Center, De Boelelaan 1117, HV Amsterdam, The Netherlands., van der Hoeven NW; Department of Cardiology, VU University Medical Center, De Boelelaan 1117, HV Amsterdam, The Netherlands., Muller FF; Department of Neurology, VU University Medical Center, De Boelelaan 1117, HV Amsterdam, The Netherlands., Appelman Y; Department of Cardiology, VU University Medical Center, De Boelelaan 1117, HV Amsterdam, The Netherlands. |
| المصدر: | European heart journal. Case reports [Eur Heart J Case Rep] 2018 Nov 27; Vol. 2 (4), pp. yty132. Date of Electronic Publication: 2018 Nov 27 (Print Publication: 2018). |
| نوع المنشور: | Case Reports |
| اللغة: | English |
| بيانات الدورية: | Publisher: Oxford University Press Country of Publication: England NLM ID: 101730741 Publication Model: eCollection Cited Medium: Internet ISSN: 2514-2119 (Electronic) Linking ISSN: 25142119 NLM ISO Abbreviation: Eur Heart J Case Rep Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Original Publication: Oxford : Oxford University Press, [2017]- |
| مستخلص: | Background: Contrast-induced encephalopathy (CIE) is a rare complication of coronary angiography (CAG) caused by a direct neurotoxic reaction to iodinated contrast medium. Contrast-induced encephalopathy can result in a variety of neurological symptoms following within minutes to hours after contrast injection. It manifests most frequently as transient cortical blindness, headache, or confusion. In the majority of known cases, symptoms completely resolve solely with supportive care. We present a case where CIE takes a more dramatic course. Case Summary: A 67-year-old woman was scheduled for elective CAG, due to progressive typical chest pain. Within minutes after injection of iso-osmolar iodinated contrast medium, the patient showed a sudden decline in consciousness while all other vital functions remained normal. Shortly, after the patient was admitted to the intensive care unit due to acute-onset coma and respiratory insufficiency. A computed tomography scan of the brain showed bilateral cerebral oedema, which in combination with the development of symptoms after contrast injection led to the diagnosis of CIE. Remarkable decrease of cerebral oedema was observed 1 day later and slowly clinical recovery ensued. After 23 days, the patient was discharged from the cardiology ward. Follow-up at the outpatient clinic showed no lasting neurological deficits. Discussion: While most symptoms of CIE are relatively mild and transient in nature, we describe a more devastating course that occurred with the use of only a low quantity of iso-osmolar contrast medium. We emphasize that even the more severe manifestations of CIE can develop at any dosage, and with all types of iodinated contrast medium. |
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| فهرسة مساهمة: | Keywords: Case report; Coronary angiography; Encephalopathy; Iodinated contrast medium; Neurotoxicity |
| تواريخ الأحداث: | Date Created: 20190426 Latest Revision: 20220408 |
| رمز التحديث: | 20231215 |
| مُعرف محوري في PubMed: | PMC6426011 |
| DOI: | 10.1093/ehjcr/yty132 |
| PMID: | 31020208 |
| قاعدة البيانات: | MEDLINE |
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