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Acute Disseminated Encephalomyelitis Following Thoracic Endovascular Aortic Repair
Cleofina Furtado1, Changrez Jadun1, Sachin Srivastava1
1Department of Diagnostic and Interventional Radiology, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, GBR.
Cureus
|November 23, 2022
Summary
Acute disseminated encephalomyelitis (ADEM) can be triggered by radiopaque contrast material, a rare cause. Early consideration of ADEM is crucial for patients with neurological symptoms post-procedure to improve outcomes.
Area of Science:
- Neurology
- Immunology
Background:
- Acute disseminated encephalomyelitis (ADEM) is a rare immune-mediated demyelinating disease of the central nervous system.
- Common triggers include infections and immunizations, but the exact mechanisms remain unclear.
Observation:
- A patient developed ADEM following thoracic endovascular aortic repair and intensive care unit stay.
- Neurological symptoms emerged after sedation weaning, with MRI confirming ADEM features.
- This case highlights challenges in diagnosing neurological issues post-intubation/sedation.
Findings:
- Radiopaque contrast material is postulated as a potential immunological trigger for ADEM in this unusual case.
- The patient's presentation and subsequent mortality underscore the severity of ADEM.
Implications:
- Clinicians and radiologists should consider ADEM in patients with neurological symptoms after radiological procedures.
- A high index of suspicion for ADEM can aid in timely diagnosis and management, potentially reducing mortality.
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