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Cerebral contrast retention after difficult cardiac catheterization: Case report.
Shahid M Khan1, David W Ho1, Jason M Lazar1
1Division of Cardiovascular Medicine, State University of New York Downstate Medical Center, Brooklyn, NY, USA.
SAGE Open Medical Case Reports
|August 5, 2016
Summary
A rare case of cerebral contrast retention occurred after cardiac catheterization in an elderly patient on prasugrel. The hyperdensity on CT scan was diagnosed as contrast leakage, not intracranial hemorrhage.
Area of Science:
- Neurology
- Cardiology
- Radiology
Background:
- A 77-year-old female presented with chest pain, diagnosed with ST-elevation myocardial infarction.
- The patient underwent cardiac catheterization with dual antiplatelet therapy (aspirin and prasugrel).
Purpose of the Study:
- To report a diagnostic dilemma in a rare case of cerebral contrast retention.
- To differentiate contrast extravasation from intracranial hemorrhage post-cardiac catheterization.
Main Methods:
- Emergent computed tomography (CT) scan of the brain revealed hyperdensity.
- Repeat CT scan at 24 hours showed significant improvement.
- Follow-up magnetic resonance imaging (MRI) of the head was normal.
Main Results:
- Initial CT findings were consistent with intracerebral bleed.
- Rapid resolution on follow-up CT and normal MRI suggested an alternative diagnosis.
- Cerebral hyperdensity was attributed to contrast leakage rather than hemorrhage.
Conclusions:
- Cerebral contrast retention is a rare complication of cardiac catheterization.
- Distinguishing contrast extravasation from intracranial hemorrhage is crucial for appropriate management.
- This case highlights the importance of correlating imaging findings with clinical presentation and follow-up.
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