Paraplegia after contrast media application: a transient or devastating rare complication? Case report

Area of Science:

• Neurology
• Radiology
• Vascular Surgery

Background:

• Spinal dural arteriovenous fistulas are rare vascular malformations.
• Angiography is crucial for diagnosing spinal vascular lesions.
• Contrast media are essential for diagnostic imaging but carry potential risks.

Observation:

• A 76-year-old man experienced sudden, recurrent, and reversible paraplegia after spinal digital subtraction angiography and CT angiography.
• The patient's symptoms resolved spontaneously, indicating a transient neurological deficit.

Findings:

• The most probable cause of the transient paraplegia is neurotoxicity induced by the contrast media.
• This adverse reaction to contrast media in the spinal cord is exceptionally rare and appears to be idiosyncratic.
• The phenomenon can occur following both intra-arterial and intravenous administration of contrast media.

Implications:

• Highlights the potential for contrast media neurotoxicity, even in rare cases.
• Emphasizes the need for vigilance regarding contrast media reactions in spinal procedures.
• Suggests individual patient susceptibility may play a role in contrast media intolerance.