A Case Report of Contrast-Induced Encephalopathy after Repeated Percutaneous Transluminal Angioplasty for Acute Middle Cerebral Artery Occlusion.
acute large vessel occlusion
contrast-induced encephalopathy
hyperperfusion syndrome
mechanical thrombectomy
reversible leukoencephalopathy
Journal
Journal of neuroendovascular therapy
ISSN: 2186-2494
Titre abrégé: J Neuroendovasc Ther
Pays: Japan
ID NLM: 101488164
Informations de publication
Date de publication:
2022
2022
Historique:
received:
31
03
2021
accepted:
12
09
2021
medline:
1
1
2022
pubmed:
1
1
2022
entrez:
28
7
2023
Statut:
ppublish
Résumé
We report a case of contrast-induced encephalopathy (CIE) after repeated percutaneous transluminal angioplasty (PTA) for acute middle cerebral artery (MCA) occlusion. An 88-year-old woman with left hemiparesis was transferred to our hospital by ambulance. MRI revealed acute MCA M1 occlusion. We performed intravenous tissue plasminogen activator therapy and PTA for right MCA occlusion, leading to complete recanalization and improvement in hemiparalysis. After approximately one week, restenosis of right MCA developed and PTA was performed again on day 11. However, her left hemiparesis exacerbated shortly thereafter. CT demonstrated leakage of contrast medium, and an extensive high-intensity area (HIA) on the white matter in the right cerebral hemisphere was noted on MRI FLAIR. The HIA on MRI and neurological deficits gradually improved after conservative treatment, but diffuse atrophy of the right cerebral hemisphere occurred and higher brain dysfunction remained. Repeated ischemia and reperfusion, and the frequent use of contrast media were considered the causes of CIE.
Identifiants
pubmed: 37502340
doi: 10.5797/jnet.cr.2021-0061
pii: jnet.cr.2021-0061
pmc: PMC10370915
doi:
Types de publication
Case Reports
Langues
eng
Pagination
371-375Informations de copyright
©2022 The Japanese Society for Neuroendovascular Therapy.
Déclaration de conflit d'intérêts
The authors declare no conflicts of interest.
Références
Neurology. 2020 Jun 9;94(23):e2491-e2494
pubmed: 32381554
Intern Med. 2014;53(18):2133-8
pubmed: 25224202
Stroke. 2020 Dec;51(12):3756-3759
pubmed: 33121385
World Neurosurg. 2010 Dec;74(6):640-4
pubmed: 21492633
Neurol Sci. 2019 Sep;40(9):1951-1953
pubmed: 30847676
Interv Neuroradiol. 2012 Mar;18(1):33-41
pubmed: 22440599
AJNR Am J Neuroradiol. 2008 Jun;29(6):1036-42
pubmed: 18356474
J Cerebrovasc Endovasc Neurosurg. 2017 Sep;19(3):184-188
pubmed: 29159151