Abstract
A 70-year-old man experiencing impaired consciousness was admitted to our hospital by ambulance. MRI showed basilar artery occlusion (BAO), and mechanical thrombectomy (MT) was performed. The patient was discharged after complete recanalization, with no obvious ischemic lesions observed. Five months later, BAO recurred, and a second MT was performed. Although recanalization was successful, CT immediately after the procedure showed inflow of contrast medium into the brainstem and cerebellar parenchyma. The patient was diagnosed with contrast-induced encephalopathy (CIE), which caused fluctuating impairment of consciousness and edematous changes in the brain parenchyma, as detected via MRI the day after treatment. Medical treatment, including steroid administration, improved both the symptoms and imaging findings. Although complete recanalization had been achieved with the first thrombectomy and no residual ischemic lesions were found on the images, it is believed that the second cerebral infarction and CIE were caused by the thrombectomy. Therefore, it is important to closely monitor the amount and injection rate of contrast medium when performing multiple thrombectomies, taking into account the risk of CIE.
