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Contrast-induced encephalopathy mimicking total anterior circulation stroke: a case report and review of the literature

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Abstract

Introduction

Contrast-induced encephalopathy is a rare and usually reversible entity due to the administration of iodinated contrast. Clinical manifestations include cortical blindness, encephalopathy, seizures and focal neurological deficits.

Methods

We report the case of a 56-year-old woman who developed global aphasia and right hemiplegia after a cerebral angiography performed for a subarachnoid haemorrhage. A prompt brain MRI resulted negative, while CT scan revealed left cerebral oedema with the cerebral sulci effacement. Complete recovery was observed in 10 days.

Discussion

Diagnosis of contrast-induced encephalopathy requires a temporal correlation between neurological dysfunction and administration of iodinated contrast. Usually, the symptomatology is transient with a full recovery within 48–72 h. The most common symptom is cortical blindness, while other symptoms have been rarely reported. Only 20 cases previously reported global aphasia and/or hemiplegia or mimed anterior circulation strokes. Prompt brain neuroimaging is essential in order to exclude an alternative diagnosis that requires a distinct therapeutic approach.

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Authors and Affiliations

  1. Neurological Department, “A. Manzoni” Hospital, ASST Lecco, Via dell’Eremo 9/11, 23900, Lecco, Italy

    Martina Vigano’, Vittorio Mantero, Paola Basilico, Davide Sangalli, Andrea Rigamonti & Andrea Salmaggi

  2. UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA

    Christian Cordano

  3. Neuroradiological Unit, “A. Manzoni” Hospital, ASST Lecco, Lecco, Italy

    Paolo Reganati & Alessandro Lunghi

Authors
  1. Martina Vigano’
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  2. Vittorio Mantero
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  3. Paola Basilico
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  4. Christian Cordano
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  5. Davide Sangalli
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  6. Paolo Reganati
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  7. Alessandro Lunghi
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  8. Andrea Rigamonti
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  9. Andrea Salmaggi
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All authors approved the contents of the manuscript and validated the accuracy of the data.

Corresponding author

Correspondence to Vittorio Mantero.

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Vigano’, M., Mantero, V., Basilico, P. et al. Contrast-induced encephalopathy mimicking total anterior circulation stroke: a case report and review of the literature. Neurol Sci 42, 1145–1150 (2021). https://doi.org/10.1007/s10072-020-04844-1

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  • DOI: https://doi.org/10.1007/s10072-020-04844-1

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