<abstract xmlns="http://www.w3.org/1999/xhtml"><p> Use of non-ionic contrast media (CM) in coronary arteriography has been reported to cause transient cortical blindness, confusion, amnesia and very rare focal deficits. We report a 69-year old patient with stable angina pectoris who underwent coronary angioplasty with stent placement due to in-stent thrombosis of the right coronary artery and developed stroke symptoms with radiological suspicion of subarachnoid hemorrhage. No vascular malformations were detected on CT cerebral angiography. Dual antiplatelet treatment was continued. Complete neurological recovery was observed within 48 hours post angiography. As observed with repeated CT scans, sulcal hyperdensities mostly faded after 24 hours and totally disappeared within 7 days when she was discharged home. Our case shows transient neurological symptoms and rapid disappearing of sulcal hyperdensities, suggesting temporary blood brain barrier disruption, consequential cerebral infarction and contrast media extravasation as the main mechanisms which allowed us to treat the patient with dual antiplatelet treatment.</p></abstract>

Use of non-ionic contrast media (CM) in coronary arteriography has been reported to cause transient cortical blindness, confusion, amnesia and very rare focal deficits. We report a 69-year old patient with stable angina pectoris who underwent coronary angioplasty with stent placement due to in-stent thrombosis of the right coronary artery and developed stroke symptoms with radiological suspicion of subarachnoid hemorrhage. No vascular malformations were detected on CT cerebral angiography. Dual antiplatelet treatment was continued. Complete neurological recovery was observed within 48 hours post angiography. As observed with repeated CT scans, sulcal hyperdensities mostly faded after 24 hours and totally disappeared within 7 days when she was discharged home. Our case shows transient neurological symptoms and rapid disappearing of sulcal hyperdensities, suggesting temporary blood brain barrier disruption, consequential cerebral infarction and contrast media extravasation as the main mechanisms which allowed us to treat the patient with dual antiplatelet treatment.

Acute ischemic stroke mimicking subarachnoid hemorrhage after coronary angioplasty

Romanian Journal of Internal Medicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Use of non-ionic contrast media (CM) in coronary arteriography has been reported to cause transient cortical blindness, confusion, amnesia and very rare focal...

Acute ischemic stroke mimicking subarachnoid hemorrhage after coronary angioplasty

Article Category: Case Report

Published Online: Aug 19, 2017

Page range: 175 - 177

Received: Dec 21, 2016

DOI: https://doi.org/10.1515/rjim-2017-0013

Keywords
neurotoxicity syndromes, contrast media, blood-brain barrier, cerebral infarction, subarachnoid hemorrhage

© 2017

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Acute ischemic stroke mimicking subarachnoid hemorrhage after coronary angioplasty

Article Category: Case Report

Published Online: Aug 19, 2017

Page range: 175 - 177

Received: Dec 21, 2016

DOI: https://doi.org/10.1515/rjim-2017-0013

Keywordsneurotoxicity syndromes, contrast media, blood-brain barrier, cerebral infarction, subarachnoid hemorrhage

© 2017

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Keywords
neurotoxicity syndromes, contrast media, blood-brain barrier, cerebral infarction, subarachnoid hemorrhage