Case Report and Literature Review on Low-Osmolar, Non-Ionic Iodine-Based Contrast-Induced Encephalopathy

Meng-Ru Liu,1 Hong Jiang,2 Xian-Lun Li,2 Peng Yang2 1Department of Cardiology, China-Japan Friendship Hospital, Peking Union Medical College, Chinese Academy of Medial Sciences, Beijing, People’s Republic of China; 2Department of Cardiology, China-Japan Friendship Hospital, Beijing, People...

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Autores principales:	Liu MR, Jiang H, Li XL, Yang P
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	contrast-induced encephalopathy coronary angiography percutaneous carotid and coronary interventions Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/8046e56feeea4fcd9f8e534be93acd6a
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spelling	oai:doaj.org-article:8046e56feeea4fcd9f8e534be93acd6a2021-12-02T15:18:26ZCase Report and Literature Review on Low-Osmolar, Non-Ionic Iodine-Based Contrast-Induced Encephalopathy1178-1998https://doaj.org/article/8046e56feeea4fcd9f8e534be93acd6a2020-12-01T00:00:00Zhttps://www.dovepress.com/case-report-and-literature-review-on-low-osmolar-non-ionic-iodine-base-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Meng-Ru Liu,1 Hong Jiang,2 Xian-Lun Li,2 Peng Yang2 1Department of Cardiology, China-Japan Friendship Hospital, Peking Union Medical College, Chinese Academy of Medial Sciences, Beijing, People’s Republic of China; 2Department of Cardiology, China-Japan Friendship Hospital, Beijing, People’s Republic of ChinaCorrespondence: Peng YangDepartment of Cardiology, China-Japan Friendship Hospital, Peking Union Medical College, Chinese Academy of Medial Sciences, Yinghua Dongjie 2, Chaoyang District, Beijing 100029, People’s Republic of ChinaTel +86-10-84205083Fax +86-10-84205081Email doctoryp1898@163.comAbstract: Contrast-induced encephalopathy (CIE) is a rare complication following percutaneous carotid and coronary interventions, and important diagnostic radiological signs include brain edema and cortical enhancement. In this report, we detail a case of probable CIE in an 84-year-old woman following a normal diagnostic coronary angiography (CAG) that involved 20 mL of the low-osmolar, non-ionic monomeric, iodine-based contrast agent iopromide (Ultravist 370). The patient was unconscious and presented with hemiparesis, hemianopia, recurrent seizures, and cardiac and respiratory arrest within minutes to hours following the procedure. Non-contrast computed tomography (CT) of the head showed increased subarachnoid density, cortical enhancement, and brain edema in the right hemisphere. Three days of rehydration, reduction in cranial pressure, and treatment with an anticonvulsant and dexamethasone resulted in a gradual recovery with no neurological deficits. This case highlights that severe neurotoxic symptoms may occur in response to low doses of low-osmolar, non-ionic, monomeric contrast agents. This finding is of importance to interventional cardiologists for diagnostic considerations and development of treatment plans.Keywords: contrast-induced encephalopathy, coronary angiography, percutaneous carotid and coronary interventionsLiu MRJiang HLi XLYang PDove Medical Pressarticlecontrast-induced encephalopathycoronary angiographypercutaneous carotid and coronary interventionsGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 15, Pp 2277-2289 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	contrast-induced encephalopathy coronary angiography percutaneous carotid and coronary interventions Geriatrics RC952-954.6
spellingShingle	contrast-induced encephalopathy coronary angiography percutaneous carotid and coronary interventions Geriatrics RC952-954.6 Liu MR Jiang H Li XL Yang P Case Report and Literature Review on Low-Osmolar, Non-Ionic Iodine-Based Contrast-Induced Encephalopathy
description	Meng-Ru Liu,1 Hong Jiang,2 Xian-Lun Li,2 Peng Yang2 1Department of Cardiology, China-Japan Friendship Hospital, Peking Union Medical College, Chinese Academy of Medial Sciences, Beijing, People’s Republic of China; 2Department of Cardiology, China-Japan Friendship Hospital, Beijing, People’s Republic of ChinaCorrespondence: Peng YangDepartment of Cardiology, China-Japan Friendship Hospital, Peking Union Medical College, Chinese Academy of Medial Sciences, Yinghua Dongjie 2, Chaoyang District, Beijing 100029, People’s Republic of ChinaTel +86-10-84205083Fax +86-10-84205081Email doctoryp1898@163.comAbstract: Contrast-induced encephalopathy (CIE) is a rare complication following percutaneous carotid and coronary interventions, and important diagnostic radiological signs include brain edema and cortical enhancement. In this report, we detail a case of probable CIE in an 84-year-old woman following a normal diagnostic coronary angiography (CAG) that involved 20 mL of the low-osmolar, non-ionic monomeric, iodine-based contrast agent iopromide (Ultravist 370). The patient was unconscious and presented with hemiparesis, hemianopia, recurrent seizures, and cardiac and respiratory arrest within minutes to hours following the procedure. Non-contrast computed tomography (CT) of the head showed increased subarachnoid density, cortical enhancement, and brain edema in the right hemisphere. Three days of rehydration, reduction in cranial pressure, and treatment with an anticonvulsant and dexamethasone resulted in a gradual recovery with no neurological deficits. This case highlights that severe neurotoxic symptoms may occur in response to low doses of low-osmolar, non-ionic, monomeric contrast agents. This finding is of importance to interventional cardiologists for diagnostic considerations and development of treatment plans.Keywords: contrast-induced encephalopathy, coronary angiography, percutaneous carotid and coronary interventions
format	article
author	Liu MR Jiang H Li XL Yang P
author_facet	Liu MR Jiang H Li XL Yang P
author_sort	Liu MR
title	Case Report and Literature Review on Low-Osmolar, Non-Ionic Iodine-Based Contrast-Induced Encephalopathy
title_short	Case Report and Literature Review on Low-Osmolar, Non-Ionic Iodine-Based Contrast-Induced Encephalopathy
title_full	Case Report and Literature Review on Low-Osmolar, Non-Ionic Iodine-Based Contrast-Induced Encephalopathy
title_fullStr	Case Report and Literature Review on Low-Osmolar, Non-Ionic Iodine-Based Contrast-Induced Encephalopathy
title_full_unstemmed	Case Report and Literature Review on Low-Osmolar, Non-Ionic Iodine-Based Contrast-Induced Encephalopathy
title_sort	case report and literature review on low-osmolar, non-ionic iodine-based contrast-induced encephalopathy
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/8046e56feeea4fcd9f8e534be93acd6a
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Case Report and Literature Review on Low-Osmolar, Non-Ionic Iodine-Based Contrast-Induced Encephalopathy

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