Transient contrast induced neurotoxicity after coronary angiography: A contrast re-challenge case | [Pakistan Journal of Medical Sciences • 2020]

Author(s):

1. Muhammad Athar Sadiq: Department of Medicine Sultan Qaboos University Hospital Al Khoudh 123, Muscat, Oman.

2. Marwa Salim Al Habsi: Department of Medicine Sultan Qaboos University Hospital Al Khoudh 123, Muscat, Oman.

3. Sunil Kumar Nadar: Department of Medicine Sultan Qaboos University Hospital Al Khoudh 123, Muscat, Oman

4. Muhammad Mujtaba Shaikh: Department of Medicine Sultan Qaboos University Hospital Al Khoudh 123, Muscat, Oman

5. Hafidh Aqeel BaOmar: Department of Medicine Sultan Qaboos University Hospital Al Khoudh 123, Muscat, Oman

Abstract:

Contrast induced neurotoxicity (CIN) is a rare complication of cardiac catheterization and re-exposure to contrast medium carries the risk of recurrent CIN. We report a case of successful contrast re-challenge in a 60-year-old female patient who developed CIN after her first procedure of coronary angiography (CAG) which resulted in symptoms of disorientation, amnesia and cortical blindness. A non-contrast enhanced CT performed four hours after the CAG was normal, however, her MRI brain scan showed scattered tiny hyper intensities in posterior occipito-temporal and parietal regions suggesting CIN. Patient's symptoms resolved completely after 72 hours. Two months later, because of persistent exertional angina, patient was successfully re-challenged with lesser amount of contrast medium with administration of hydrocortisone prior to procedure, and PCI to LAD was completed without recurrence of CIN.

Page(s): 1140-1142

DOI: DOI not available

Published: Journal: Pakistan Journal of Medical Sciences, Volume: 36, Issue: 5, Year: 2020

Keywords:

Contrast induced neurotoxicity , Contrast rechallenge

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