• Xianzeng Tong, Peng Hu, Tao Hong, Meng Li, Peng Zhang, Guilin Li, and Hongqi Zhang.
• Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, and China International Neuroscience Institute (China-INI), Beijing, China.
• World Neurosurg. 2018 Nov 1; 119: 123-131.

BackgroundWe presented 3 cases of transient cortical blindness secondary to contrast medium toxicity after endovascular procedures for intracranial aneurysms. We also reviewed the literature and found 12 cases of contrast-induced cortical blindness after endovascular procedures for intracranial aneurysms.Case DescriptionTwo patients (cases 1 and 2) noted bilateral blindness 5 and 6 hours, respectively, after awakening from general anesthesia following aneurysm treatment. The third patient (case 3) noted bilateral blindness during vertebral angiography under local anesthesia. Immediate angiography was performed in case 1 and showed no arterial occlusion. Computed tomography was performed in case 2 and showed brain edema. Magnetic resonance imaging was performed in all 3 cases, and cases 2 and 3 showed abnormal presentation on fluid attenuated inversion recovery sequences. With the use of corticosteroid and intravenous hydration, cortical blindness resolved within 1 week in 2 patients (Cases 1 and 2). The remaining patient (case 3) had incomplete quadrantanopia 3 months after blindness onset.ConclusionsBased on our experience and the literature reports, we advocate corticosteroid and intravenous hydration for patients with contrast-induced cortical blindness after endovascular procedures for intracranial aneurysms.Copyright © 2018 Elsevier Inc. All rights reserved.

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