A Case Report of Contrast-Induced Encephalopathy after Repeated Percutaneous Transluminal Angioplasty for Acute Middle Cerebral Artery Occlusion

Haruki Otsubo; Tomohide Yoshie; Takashi Araga; Kentaro Tatsuno; Satoshi Takaishi; Noriko Usuki; Yasuyuki Yoshida; Hajime Ono; Toshihiro Ueda

doi:10.5797/jnet.cr.2021-0061

この記事には本公開記事があります。本公開記事を参照してください。
引用する場合も本公開記事を引用してください。

A Case Report of Contrast-Induced Encephalopathy after Repeated Percutaneous Transluminal Angioplasty for Acute Middle Cerebral Artery Occlusion

Haruki Otsubo, Tomohide Yoshie, Takashi Araga, Kentaro Tatsuno, Satoshi Takaishi, Noriko Usuki, Yasuyuki Yoshida, Hajime Ono, Toshihiro Ueda

著者情報

Haruki Otsubo
Stroke Center, St. Marianna University Toyoko Hospital, Kawasaki, Kanagawa, Japan
Tomohide Yoshie
Stroke Center, St. Marianna University Toyoko Hospital, Kawasaki, Kanagawa, Japan
Takashi Araga
Stroke Center, St. Marianna University Toyoko Hospital, Kawasaki, Kanagawa, Japan
Kentaro Tatsuno
Stroke Center, St. Marianna University Toyoko Hospital, Kawasaki, Kanagawa, Japan
Satoshi Takaishi
Stroke Center, St. Marianna University Toyoko Hospital, Kawasaki, Kanagawa, Japan
Noriko Usuki
Stroke Center, St. Marianna University Toyoko Hospital, Kawasaki, Kanagawa, Japan
Yasuyuki Yoshida
Stroke Center, St. Marianna University Toyoko Hospital, Kawasaki, Kanagawa, Japan
Hajime Ono
Stroke Center, St. Marianna University Toyoko Hospital, Kawasaki, Kanagawa, Japan
Toshihiro Ueda
Stroke Center, St. Marianna University Toyoko Hospital, Kawasaki, Kanagawa, Japan

キーワード: contrast-induced encephalopathy, reversible leukoencephalopathy, hyperperfusion syndrome, mechanical thrombectomy, acute large vessel occlusion

ジャーナルオープンアクセス早期公開

論文ID: cr.2021-0061

DOI https://doi.org/10.5797/jnet.cr.2021-0061

この記事には本公開記事があります。

The final version of this article is now available: Vol. 16 (2022), No. 7 pp. 371-375

詳細

抄録

Objective: We report a case of contrast-induced encephalopathy (CIE) after repeated percutaneous transluminal angioplasty (PTA) for acute middle cerebral artery (MCA) occlusion.

Case Presentation: An 88-year-old woman with left hemiparesis was transferred to our hospital by ambulance. MRI revealed acute MCA M1 occlusion. We performed intravenous tissue plasminogen activator therapy and PTA for right MCA occlusion, leading to complete recanalization and improvement in hemiparalysis. After approximately one week, restenosis of right MCA developed and PTA was performed again on day 11. However, her left hemiparesis exacerbated shortly thereafter. CT demonstrated leakage of contrast medium, and an extensive high-intensity area (HIA) on the white matter in the right cerebral hemisphere was noted on MRI FLAIR. The HIA on MRI and neurological deficits gradually improved after conservative treatment, but diffuse atrophy of the right cerebral hemisphere occurred and higher brain dysfunction remained.

Conclusion: Repeated ischemia and reperfusion, and the frequent use of contrast media were considered the causes of CIE.

責任著者(Corresponding author)

J-STAGEへの登録はこちら（無料）