Contrast-induced encephalopathy (CIE) – a rare complication of coronary angiography: case report

Abstract

Contrast-induced encephalopathy (CIE) is a rare complication of contrast-mediated endovascular therapeutic and diagnostic procedures, presenting itself with a wide range of reversible and nonspecific neurological symptoms.
According to current literature data, the incidence of CIE is between 0.3% and 2%, and the risk of it depends on the type of the procedure, the patient’s comorbidities and the type of the used contrast medium. At the moment, the exact dose of contrast that leads to neurological complications has not been defined, but most studies accept that 200 ml. is the maximum safe dose to avoid neurotoxicity.
Clinically, CIE presents with heterogeneous neurological symptoms, acute onset and complete recovery within 72 hours. However, the diagnosis of CIE is often a challenge, and performing a CT scan of the brain is not always informative, because sometimes there no detectаble abnormalities on it.
We present a clinical case of an 81-year-old comorbid female patient, suffering from arterial hypertension and chronic kidney damage.
She underwent a coronarography and 12 hours later the patient had a seizure and the brain CT scan showed abnormal extravasation of contrast medium.