[Cerebral contrast medium extravasation after coronary angioplasty]

We report on an 82-year-old woman who suffered a sudden loss of consciousness, right-sided hemiparesis, and aphasia during a coronary angiographic procedure. Computed tomography (CT) of the brain performed immediately revealed an edema and extravascularly localized contrast media in the left hemisphere. Within 6 h, neurological symptoms had disappeared, and a second CT after 48 h revealed normal results. Usually, extravasation of contrast media affects the posterior circulation with cortical blindness. This case demonstrates that contrast media may affect the blood-brain barrier also outside the posterior circulation. If neurological symptoms occur during angiography, contrast media extravasation must be distinguished from embolism or vasospasm induced by the angiographic procedure.