[Prolonged reversible cortical blindness over 5 days after cardiac catheterization]

Med Klin Intensivmed Notfmed. 2017 Sep;112(6):535-539. doi: 10.1007/s00063-016-0236-y. Epub 2016 Dec 20.
[Article in German]

Abstract

We present a case of a 49-year-old man with angina pectoris. He developed transient cortical blindness (TCB) with focal neurological symptoms following coronary angiography. Two cranial magnet resonance studies within 3 days showed no morphological changes. Clinically the patient developed complex focal epilepsy, which was symptomatically treated. Under intensive monitoring, including hypertension control, the patient improved after 5 days of blindness with restoration of his vision on day 6. The exact mechanism of TCB is still speculative, but could be caused in this case by a toxic effect of contrast dye that was administered. There is no definitive evidence to suggest that a certain treatment regime improves the natural history of the disease. However, control of risk factors and prevention of selective cerebral angiography may increase preventive strategies for this highly devastating complication.

Keywords: Aortocoronary bypass operation; Contrast media; Coronary angiography; PRES; Transient cortical blindness.

Publication types

  • Case Reports

MeSH terms

  • Blindness, Cortical* / etiology
  • Cardiac Catheterization* / adverse effects
  • Contrast Media
  • Coronary Angiography
  • Humans
  • Male
  • Middle Aged
  • Risk Factors

Substances

  • Contrast Media