Transient cortical blindness after coronary angiography

Area of Science:

• Neurology
• Radiology
• Cardiology

Background:

• Coronary angiography is a common procedure for diagnosing heart conditions.
• Contrast media are routinely used to visualize blood vessels during angiography.
• Potential adverse neurological events associated with contrast media are a concern.

Observation:

• A 62-year-old male patient presented with a three-day episode of transient visual loss.
• The visual loss occurred subsequent to undergoing transfemoral coronary angiography.
• Computed tomography (CT) revealed bilateral contrast medium leakage into the occipital cortex.

Findings:

• Repeat CT scans demonstrated complete clearance of the contrast medium upon visual recovery.
• No evidence of underlying infarction was detected in the occipital cortex.
• The observed neurological changes suggest a breakdown of the blood-brain barrier (BBB) and potential direct neurotoxicity of the contrast media.

Implications:

• This case suggests a previously unreported mechanism of neurological complications following coronary angiography.
• Contrast media may possess direct neurotoxic properties leading to temporary BBB disruption.
• Further investigation into the neurotoxicity of contrast agents and their impact on the BBB is warranted.