Iodinated contrast-induced encephalopathy: a pathology that must be borne in mind when carrying out endovascular examinations
*Correspondencia: Dra. María Isabel Morales Casado. Servicio de Neurología. Hospital Virgen de la Salud. Avda. Barber, 30. E-45003 Toledo.
E-mail: mimorales@sescam.jccm.es
Introduction: In recent years there has been an increase in the number of endovascular examinations in the study of both cardiovascular and cerebrovascular diseases. One very infrequent complication is neurotoxicity due to contrast, and it must be suspected within the context of a neurological deficit following such examinations in order to be able to diagnose it.
Case report: A 61-year-old male who presented an epileptic attack and later deficit in the left hemisphere following diagnostic arteriography. After ruling out the possibility of an urgent vascular pathology, he was submitted to a magnetic resonance brain scan with the suspicion of this condition. The clinical signs and symptoms were limited to 72 hours with cortisone therapy.
Conclusions: Contrast-induced encephalopathy covers a wide range of clinical features which, in the vast majority of cases, are self-limiting to 24-72 hours, and within the context of neuronal damage following contrast infusion. Its prognosis is excellent, and diagnostic suspicion is crucial in its treatment.
Caso clínico Varón de 61 años que tras una arteriografía diagnóstica en el estudio de una hemorragia subaracnoidea presentó una crisis epiléptica y posteriormente déficit hemisférico izquierdo. Tras descartar una patología vascular urgente, se realizó una resonancia magnética cerebral con sospecha de encefalopatía poscontraste. La clínica se limitó en 72 horas con corticoterapia.
Conclusiones La encefalopatía por contraste abarca un amplio espectro clínico, en la inmensa mayoría de los casos autolimitado en 24-72 horas, y en el contexto del daño neuronal tras la infusión de contraste. Su pronóstico es excelente y la sospecha diagnóstica es vital en el tratamiento.
