Contrast-induced encephalopathy following cardiac catheterization

Area of Science:

• Neurology
• Radiology
• Cardiology

Background:

• Contrast-induced encephalopathy (CIE) is an acute, reversible neurological disturbance.
• It is directly attributable to intra-arterial administration of iodinated contrast medium during cardiac catheterization.

Purpose of the Study:

• To describe the epidemiology, pathophysiology, clinical presentation, and management of CIE.
• To raise awareness among physicians for differential diagnosis and appropriate management.

Main Methods:

• A comprehensive literature search of the PubMed database was conducted.
• All reported cases of CIE following cardiac catheterization were retrieved and reviewed.

Main Results:

• 52 reports of CIE were identified, with transient cortical blindness being the most common syndrome (approx. 50%).
• Symptoms appear within hours and resolve within 48 hours. Risk factors include hypertension, diabetes, renal impairment, and large contrast volumes.
• Cerebral imaging may show contrast enhancement, mimicking stroke; CT Hounsfield scale and MRI ADC are crucial for differentiation.

Conclusions:

• CIE is an important consideration in the differential diagnosis of post-cardiac catheterization neurological events.
• Given the excellent prognosis with supportive management, awareness is crucial to avoid unnecessary interventions like thrombolysis.