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13 November 2020: Articles

Contrast-Induced Transient Neurological Symptoms Following Percutaneous Coronary Intervention: A Case Report

Challenging differential diagnosis, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents, Unexpected drug reaction , Rare disease, Clinical situation which can not be reproduced for ethical reasons

Aishah Albakr A* , Noman Ishaque E , Danah Aljaafari F , Sabah N. Sairafi E

DOI: 10.12659/AJCR.926956

Am J Case Rep 2020; 21:e926956

Table 1. Case reports of patients who have undergone PCI and developed focal neurological symptoms.

StudyAge/sexRisk factorsType and dose of the contrastNeurological findingsThe onset of the neurological symptoms after PCINeuroimaging findingsTreatmentOutcome
Law S, et al. (2012) []12 69y/FHTN, DM, impaired renal functionIodixanol, 320 mgI/mLSeizures, left-sided weakness, homonymous hemianopia, hemisensory loss, and hemineglect12 hInitial CT: frontal and parietal lobes edemaIntravenous thrombolysisComplete recovery within 24 h. Complete resolution on follow up, 32-h MRI and 84-h CT
Heemlar JC, et al. (2018) []13 67 y/FHTN/DMIodixanol, 100 mlAltered level of consciousness, right-sided hypertonia and bilateral upgoing plantar0–4 hCT: right-sided hypodensities in the watershed regions. Repeated scan at 4h showed diffuse bilateral cerebral edemaIntubation, dexamethasone, and levetiracetam4 days: marked improvement. 3 weeks: complete resolution of the radiological findings on MRI. 6 weeks follow up: complete neurological recovery
Raju NS, et al. (2015) []14 44 y/FHTN/DM/ ESRD on peritoneal dialysisIohexol (Omnipaque 350), 190 mLHeadache, seizure, and left-sided weaknessA few hoursCT: contrast retention in the right cerebral hemisphere and left cerebral hemisphere watershed territoriesLorazepam and levetiracetam for seizures, peritoneal dialysisComplete recovery within 3 days
Yıldız A, et al. (2003) []15 63 y/MNAIomeprol (imeron), 450 mlAmnesia, headache and right upper extremity numbnessNACT: contrast retention at the right frontal, occipital, and parietal lobesDexamethasoneComplete neurological and radiological recovery within 25 h
Velden J, et al. (2003) []16 82 y/FHTN, impaired renal functionIomeprol (imeron), 500 mlAltered LOC, Malignant HTN, aphasia, and right-side hemiparesis6 hCT: contrast retention the sulci of both brain hemispheresClose observation, supportive careComplete recovery at 40 h

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923