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Possible increased tendency to thrombosis after cerebral angiography
Acta Neurologica Scandinavica
|March 1, 1979
Summary
Cerebral angiography complications, including vision loss from occipital infarcts, may stem from coagulation disturbances. Proactive coagulation assessment and treatment before/after angiography are recommended for patients with transient cerebral ischemia.
Area of Science:
- Neurology
- Vascular Medicine
- Ophthalmology
Background:
- Cerebral angiography is a diagnostic tool for cerebrovascular diseases.
- Potential complications include ischemic events like occipital infarcts.
- Coagulation status may influence the risk of such complications.
Observation:
- Two patients developed bilateral occipital infarcts post-cerebral angiography, leading to cortical blindness and visual field defects.
- Case 1 showed compensated disseminated intravascular coagulation, resolving with phenprocoumon.
- Case 2 exhibited increased spontaneous platelet aggregability, successfully managed with aspirin and dipyridamole.
Findings:
- Coagulation abnormalities were identified following cerebral angiography in both patients.
- These post-angiography coagulation disturbances are hypothesized as the cause of the infarcts.
- Treatment targeting specific coagulation issues (anticoagulation or antiplatelet therapy) proved effective.
Implications:
- Patients undergoing cerebral angiography for transient cerebral ischemia or stroke require pre- and post-procedure coagulation evaluation.
- Early detection and management of coagulation disturbances can potentially prevent severe neurological and visual complications.
- This highlights the importance of a multidisciplinary approach in managing patients at risk for cerebrovascular events during diagnostic procedures.