Transient contrast encephalopathy after carotid artery stenting mimicking diffuse subarachnoid hemorrhage: a case report

Catheter Cardiovasc Interv. 2009 Jan 1;73(1):123-6. doi: 10.1002/ccd.21779.

Abstract

Several types of brain injury incurred during carotid artery stenting (CAS), such as embolic injury, hemodynamic events, and hemorrhage. Rapid differential diagnosis is important for decision making, and may help to avoid subsequent complications. Here, we describe a case with severe triple vessel coronary artery disease, who underwent right coronary artery (RCA) stenting and ad hoc left CAS. Patient developed neurological deficit two hours after the procedure. Brain computed tomography (CT) revealed diffuse cortical enhancement similar to subarachnoid hemorrhage (SAH). Patient recovered dramatically with complete resolution of contrast enhancement after four days of conservative treatment, final diagnosis was a rare reported case of transient contrast encephalopathy.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Angioplasty, Balloon / instrumentation*
  • Angioplasty, Balloon, Coronary / instrumentation
  • Carotid Stenosis / complications
  • Carotid Stenosis / diagnostic imaging
  • Carotid Stenosis / therapy*
  • Contrast Media / adverse effects*
  • Coronary Angiography
  • Coronary Stenosis / complications
  • Coronary Stenosis / diagnostic imaging
  • Coronary Stenosis / therapy*
  • Diagnosis, Differential
  • Diffusion Magnetic Resonance Imaging
  • Humans
  • Male
  • Neurotoxicity Syndromes / diagnosis*
  • Neurotoxicity Syndromes / etiology
  • Neurotoxicity Syndromes / pathology
  • Radiography, Interventional*
  • Remission, Spontaneous
  • Stents*
  • Subarachnoid Hemorrhage / diagnosis*
  • Tomography, X-Ray Computed

Substances

  • Contrast Media