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Contrast-induced encephalopathy: a complication of coronary angiography
  1. Tharanga Geethapriya Fernando1,
  2. Shanika Nandasiri2,
  3. Sepalika Mendis1,
  4. Sunethra Senanayake2,
  5. Inuka Kishara Gooneratne2,
  6. Rayno Navinan1,
  7. Ambiga Kadiragamanathan1,
  8. Sumudu Wickramasinghe1,
  9. Tharuka Herath2,
  10. Narmathey Thambirajah2,
  11. Romesh Markus3
  1. 1Cardiology, National Hospital of Sri Lanka, Colombo, Sri Lanka
  2. 2Neurology, National Hospital of Sri Lanka, Colombo, Sri Lanka
  3. 3Department of Neurology, St Vincent’s Hospital, Sydney, Australia
  1. Correspondence to Tharanga Geethapriya Fernando, Cardiology, National Hospital of Sri Lanka, Colombo 01000, Sri Lanka; tharangafernando9{at}gmail.com

Abstract

Contrast-induced encephalopathy is a rare idiosyncratic reaction to contrast material. A 56-year-old woman with hypertension developed a hemiparesis with confusion and disorientation 3 hours after routine coronary angiography. The procedure had been prolonged, and during it she had received 130 mL of iopromide contrast. A metabolic screen was negative, and cerebral angiography and MR scan of brain were normal. She recovered completely by day 5. Contrast-induced encephalopathy should be considered in patients developing focal neurological deficits following coronary angiography. Patients requiring investigations to exclude acute stroke in this setting should not receive additional intravenous or intra-arterial contrast, although MR with gadolinium appears safe. Better awareness of this complication should avoid potentially harmful interventions such as thrombolysis.

  • Cardiology
  • Hemiplegia
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Footnotes

  • Competing interests None declared.

  • Patient consent for publication Consent obtained directly from patient(s).

  • Provenance and peer review Not commissioned. Externally peer reviewed by Anthony Pereira, London, UK.

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