Transient Cortical Blindness Associated with Endovascular Procedures for Intracranial Aneurysms.

Abstract

BACKGROUND:

We presented 3 cases of transient cortical blindness secondary to contrast medium toxicity after endovascular procedures for intracranial aneurysms. We also reviewed the literature and found 12 cases of contrast-induced cortical blindness after endovascular procedures for intracranial aneurysms.

CASE DESCRIPTION:

Two patients (cases 1 and 2) noted bilateral blindness 5 and 6 hours, respectively, after awakening from general anesthesia following aneurysm treatment. The third patient (case 3) noted bilateral blindness during vertebral angiography under local anesthesia. Immediate angiography was performed in case 1 and showed no arterial occlusion. Computed tomography was performed in case 2 and showed brain edema. Magnetic resonance imaging was performed in all 3 cases, and cases 2 and 3 showed abnormal presentation on fluid attenuated inversion recovery sequences. With the use of corticosteroid and intravenous hydration, cortical blindness resolved within 1 week in 2 patients (Cases 1 and 2). The remaining patient (case 3) had incomplete quadrantanopia 3 months after blindness onset.

CONCLUSIONS:

Based on our experience and the literature reports, we advocate corticosteroid and intravenous hydration for patients with contrast-induced cortical blindness after endovascular procedures for intracranial aneurysms.

• Authors: Xianzeng Tong, Peng Hu, Tao Hong, Meng Li, Peng Zhang, Guilin Li, Hongqi Zhang
• Journal: World neurosurgery (World Neurosurg) Vol. 119 Pg. 123-131 (Nov 2018) ISSN: 1878-8769 [Electronic] United States
• PMID: 30077753 (Publication Type: Case Reports, Journal Article, Review)
• Copyright: Copyright © 2018 Elsevier Inc. All rights reserved.

Topics

• Blindness, Cortical (diagnostic imaging, drug therapy, etiology)
• Endovascular Procedures (adverse effects)
• Female
• Humans
• Intracranial Aneurysm (surgery)
• Male
• Middle Aged
• Postoperative Complications (diagnostic imaging, drug therapy)