Contrast Medium-Induced Encephalopathy After Coronary Angiography- Case Report.
Contrast Medium-Induced Encephalopathy After Coronary Angiography- Case Report.
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DOI：
10.2478/jccm-2021-0010
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发表时间：
2021-04
期刊：
影响因子：
--
通讯作者：
Maier S
中科院分区：
文献类型：
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作者：
Andone S;Balasa R;Barcutean L;Bajko Z;Ion V;Motataianu A;Stoian A;Maier S
造影剂诱发的脑病是静脉或动脉内暴露于造影剂后出现的一种罕见、可逆的并发症。关于作用机制，文献中尚无共识。然而，理论机制是围绕血脑屏障的破坏和造影剂的化学性质而建立的。报告了一例70岁患者，已知患有高血压和2型糖尿病。患者接受了诊断性冠状动脉血管造影术，期间接受了100 ml碘佛醇（Optiray 350™）。手术后不久，患者开始出现搏动性头痛，随后出现强烈的行为变化和攻击性倾向。他被转移到神经科诊所。神经系统检查无局灶性神经系统体征;然而，患者非常积极且不合作。CT扫描显示额叶轻度高密度。MRI扫描未发现病理改变。给予利尿剂和水化的保守治疗，患者在72小时内症状完全缓解。造影剂诱发的脑病是造影剂的一种可能的继发性并发症，也是一种诊断挑战，不应忽视，尤其是在使用造影剂的手术后。
Contrast-induced encephalopathy represents a rare, reversible complication that appears after intravenous or intra-arterial exposure to contrast agents. There is no consensus in the literature regarding the mechanism of action. However, the theoretical mechanism is set around the disruption of the blood-brain barrier and the contrast agents’ chemical properties. The case of a 70-year-old patient, known to have hypertension and type 2 diabetes mellitus is reported. The patient had undergone a diagnostic coronary angiography during which he received 100ml of Ioversol (Optiray 350™). Soon after the procedure, the patient began experiencing a throbbing headache, followed by intense behavioural changes and aggressive tendencies. He was transferred to the Neurology Clinic. The neurological examination was without focal neurological signs; however, the patient was very aggressive and uncooperative. The CT scan revealed a mild hyper-density in the frontal lobes. MRI scan revealed no pathological changes. Conservative treatment with diuretics and hydration was administered, and the patient experienced a complete resolution of symptoms in 72 hours. Contrast-induced encephalopathy is a possible secondary complication to contrast agents and a diagnostic challenge, and it should not be overlooked, especially following procedures that use contrast agents.