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      Vasogenic Cerebral Edema following CT Myelogram with Nonionic Omnipaque 300

      case-report
      Author(s): 1 , , 2
      Publication date (Electronic):
      Journal: Case Reports in Neurological Medicine
      Publisher: Hindawi

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          Abstract

          Computed Tomography (CT) with myelogram is a relatively safe procedure. It requires the use of nonionic contrast agents which, unlike ionic contrast agents, have been associated with low complication rates. We report a case of a 69-year-old female who developed diffuse bilateral cerebral edema following a lumber myelogram with the use of intrathecal nonionic contrast agent Omnipaque (Iohexol) 300. We were able to find one other reported case of cerebral edema following the use of intrathecal nonionic contrast agent in the literature.

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          Cerebral edema.

          Mai-Lan Ho, Rafael Rojas-Rojas, Ronald L Eisenberg (2012)
          Article 0 comments Cited 35 times – based on 0 reviews     Review now
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            Transient encephalopathy from angiographic contrast: a rare complication in neurointerventional procedures.

            Lluís Soler, Teresa Sola, Leopoldo Guimaraens … (2010)
            Neurotoxicity from contrast media used in angiography is a rare complication from these procedures. The infrequency with which it is encountered makes it a diagnostic challenge. We present the case of a 51-year-old male who, 30 min after successful angiography for treatment of a right carotid-ophthalmic fusiform aneurysm with a stent, developed psychomotor agitation, disorientation, and progressive left faciobrachial hemiparesis (4/5). An emergency nonenhanced CT showed marked cortical enhancement and edema in the right cerebral hemisphere. Cortical enhancement is thought to be secondary to contrast extravasation due to disruption of the blood-brain barrier. Angiography was performed immediately, without any pathologic findings. After this procedure there was an increase in the left faciobrachial hemiparesis (3/5), right gaze deviation, Gerstmann syndrome, and left anosognosia and left homonymous hemianopsia. Endovenous dexamethasone and mannitol were initiated. Twenty-four hours later an MRI showed no signs of acute infarct, just gyriform signal increase in the right cerebral hemisphere on FLAIR and a decrease in the edema observed before. The patient had progressive improvement of his neurological deficit. A control MRI done 5 days later was normal. The patient recovered completely and was discharged. This rare entity should be kept in mind but diagnosed only when all other causes have been ruled out, because more important and frequent causes, such as acute infarct, must be excluded promptly.
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              Cerebral Edema and its Management

              SK JHA (2003)
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                Author and article information

                Contributors
                Sara Khodor:
                ORCID: http://orcid.org/0000-0001-8255-790X
                Journal
                Journal ID (nlm-ta): Case Rep Neurol Med
                Journal ID (iso-abbrev): Case Rep Neurol Med
                Journal ID (publisher-id): CRINM
                Title: Case Reports in Neurological Medicine
                Publisher: Hindawi
                ISSN (Print): 2090-6668
                ISSN (Electronic): 2090-6676
                Publication date Collection: 2018
                Publication date (Electronic): 22 May 2018
                Volume: 2018
                Electronic Location Identifier: 2761872
                Affiliations
                1University of South Florida, Tampa, FL, USA
                2South Florida Neurology Associates, Boca Raton, FL, USA
                Author notes

                Academic Editor: Dennis J. Rivet

                Author information
                http://orcid.org/0000-0001-8255-790X
                Article
                DOI: 10.1155/2018/2761872
                PMC ID: 5987242
                SO-VID: c46f5f05-f6f9-42a9-a350-eecfc47005b8
                Copyright © Copyright © 2018 Sara Khodor and Scott Blumenthal.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 15 December 2017
                Date accepted : 8 April 2018
                Categories
                Subject: Case Report

                Data availability:

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