Contrast-Induced Encephalopathy Post Cardiac Catheterization, A Rare Mimicry of Acute Stroke - Case Presentation and Review of the Literature

Julian C. Dunkley¹, Krunal H. Patel¹, Andrew V. Doodnauth¹, Pramod Theetha Kariyanna², Emmanuel Valery¹ and Samy I. McFarlane^1,

¹Department of Internal Medicine, State University of New York: Downstate Medical Center, Brooklyn, New York, United States- 11203

²Division of Interventional Cardiology, Mount Sinai Heart, Icahn School of Medicine at Mount Sinai Morningside/Beth Israel Hospitals, New York City, NY-10025, U.S.A.

Cite this paper:
Julian C. Dunkley, Krunal H. Patel, Andrew V. Doodnauth, Pramod Theetha Kariyanna, Emmanuel Valery and Samy I. McFarlane. Contrast-Induced Encephalopathy Post Cardiac Catheterization, A Rare Mimicry of Acute Stroke - Case Presentation and Review of the Literature. American Journal of Medical Case Reports. 2021; 9(5):291-294. doi: 10.12691/ajmcr-9-5-8

Abstract

Contrast-induced encephalopathy (CIE) or contrast-induced neurotoxicity is a rare, elusive, and puzzling diagnostic entity, even for most astute clinicians. Only a handful of publications have been written describing this rare phenomenon. A recent systematic review has only identified a total of 52 cases between 1970 - 2017 [1]. The most common neurological complication associated with cardiac catheterization is an atheroembolic stroke. CIE is not a well-known complication. Clinicians involved in administering high volumes of contrast solutions, as seen in coronary catheterizations, should be aware of this complication as it may be misdiagnosed as an acute stroke, leading to unnecessary additional contrast administration for imaging, as well as invasive and non-invasive interventions. In this report we present a case of an 87-year-old woman known coronary artery disease (CAD) who presented with acute coronary syndrome (ACS) and underwent a successful cardiac catheterization with stent placement followed by left-sided weakness a few hours later due to CIE. We also provide review of the literature and discuss management strategy of this rather rarely encountered diagnosis.

Keywords:
contrast-induced encephalopathy contrast-induced neurotoxicity stroke cardiac catheterization

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