碘克沙醇致对比剂脑病CSCD

1例71岁男性患者因右侧颈总动脉及颈内动脉重度狭窄,局麻下接受主动脉弓造影+全脑动脉造影+右侧颈内动脉支架置入术,使用的对比剂为碘克沙醇注射液。术前患者头部CT未见明显异常。术后10 h患者出现发热、嗜睡、饮水呛咳、不完全运动性失语、左侧肢体肌力和肌张力减低及抽搐等神经系统症状。头部磁共振成像(MRI)示右侧大脑皮层信号增高、脑沟变浅,考虑为碘克沙醇引起的对比剂脑病。给予补液、糖皮质激素、甘露醇脱水等对症治疗3 d后,患者症状好转,头部MRI示右侧大脑皮层高信号降低、脑沟恢复正常。

Contrast-induced encephalopathy following angiography with iodixanolCSCD

A 71-year-old male patient with severe stenosis of the right common carotid artery and internal carotid artery underwent aortography+cerebral arteriography+right internal carotid artery stenting under local anesthesia with contrast medium iodixanol injection. Head CT before operation showed no obvious abnormality. Ten hours after the operation, the patient developed neurological symptoms such as fever, drowsiness, choking in drinking water, incomplete motor aphasia, decrease of muscle strength and tension of left limb, convulsions, etc. Brain magnetic resonance imaging (MRI) showed increased signal intensity in the right cerebral sulcus and sulcus shallower. Contrast-induced encephalopathy caused by iodixanol was considered. After 3 days of symptomatic treatments with rehydration, glucocorticoid, and mannitol, the patient's symptoms were improved. Brain MRI showed that the hyperintensity of right cerebral cortex decreased and the sulcus gradually returned to normal. © 2021 Chinese Medical Association