Contrast medium extravasation from aneurysmal rupture during cerebral angiography

Area of Science:

• Neurology
• Radiology
• Medical Imaging

Background:

• Contrast medium extravasation during cerebral angiography is a rare complication.
• Intracranial aneurysms causing subarachnoid hemorrhage are typically investigated using angiography.

Observation:

• Three new cases of contrast extravasation were identified over 15 years.
• A total of 17 cases, including previously reported ones, were analyzed.
• Ventricular opacification occurred in five cases, with one case showing intraventricular hematomas outlined by contrast medium.

Findings:

• No common etiological factor was identified for contrast extravasation.
• Contrast medium extravasation is associated with an extremely high mortality rate, exceeding that of aneurysmal re-bleeding or intracerebral hematoma alone.
• Only three of 17 patients survived, with two experiencing significant neurological deficits.

Implications:

• Further research into intracaratid pressures is warranted to understand extravasation mechanisms.
• The presence of contrast medium outlining intraventricular hematomas may have prognostic significance.
• Contrast medium extravasation represents an additional hazardous insult in patients with ruptured intracranial aneurysms, contributing to poor outcomes.