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Updated: Mar 31, 2026
Double Direct Injection of Blood into the Cisterna Magna as a Model of Subarachnoid Hemorrhage
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Diffuse Fluid-Attenuated Inversion Recovery Hyperintensity in Subarachnoid Space Following Cerebral Angiography and
Ramin Zand1, Shailesh Male2, John K Lynch1
1Section on Stroke Diagnostics and Therapeutics, National Institute of Neurological Disorders and Stroke, Bethesda, Maryland.
Objective:
Transient cortical blindness (TCB) is a relatively rare but well-recognized complication following cardiovascular and cerebral angiography.
Methods:
A 68-year-old male developed TCB following cerebral angiography along with punctate diffusion lesion evident on emergent magnetic resonance imaging (MRI). The patient received intravenous tissue plasminogen activator (IV-tPA) for suspected stroke.
Results:
Follow-up MRI revealed diffuse hyperintensities in subarachnoid space in fluid-attenuated inversion recovery (FLAIR) sequence mostly in bilateral occipital lobes.
Conclusion:
The finding on the FLAIR as described in this case is an indication of diffuse disruption of the blood-brain barrier perhaps secondary to cerebral angiography, high blood pressure, and IV-tPA. To the best of our knowledge, this is the first reported case of TCB with diffuse postcontrast FLAIR changes.
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