• Medicine · Jan 2021

    Case Reports

    Cardiorespiratory arrest after iso-osmolar iodinated contrast injection: A case report of contrast-induced encephalopathy following contrast-enhanced computed-tomography.

    • Li-Ding Yao, Xiu-Liang Zhu, Run-Lin Yang, and Min-Ming Zhang.
    • Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
    • Medicine (Baltimore). 2021 Jan 15; 100 (2): e24035e24035.

    RationaleContrast-induced encephalopathy (CIE) is a rare complication caused by administration of intravascular contrast media and characterized by acute reversible neurological disturbance. Most of the CIE cases are reported after arterial administration of contrast media such as during cerebral or coronary angiographies, yet only a few articles have reported CIE secondary to intravenous contrast. A case of CIE secondary to intravenous contrast administration is reported here.Patient ConcernsA 68-year-old man was admitted to our hospital for contrast-enhanced chest computed-tomography (CT) examination due to suspected pulmonary nodules. After CT examination, the patient lost consciousness and experienced a cardiorespiratory arrest. An emergency plain brain CT was done immediately which showed abnormal cortical contrast enhancement and cerebral sulci hyperdensity.DiagnosesAfter excluding other differential diagnoses such as electrolytes imbalance, hypo/hyperglycemia, cardiogenic pathologies and other neurological emergencies such as cerebral hemorrhage, cerebral infarction, the final diagnosis of CIE was made.InterventionsThe patient was admitted to the intensive care unit for further management. A series of supportive treatments were arranged.OutcomesFollow-up visits at the outpatient clinic showed no lasting neurological deficits.LessonsCIE should be considered as 1 of the differential diagnoses for a patient with acute neurologic symptoms after iodinate contrast administration. Neuroradiological imaging examinations are essential to rule out other etiologies such as acute cerebral infarction or intracranial hemorrhage.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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