表现为短暂性全面性遗忘的心脏造影术后碘对比剂脑病1例A case of contrast-induced encephalopathy with transient global amnesia after cardiac catheterization
陈怡粤,邓鸣,房子熙,余小平
摘要(Abstract)：
报道1例冠心病合并肥厚型心肌病患者行冠状动脉造影及左心室造影术后40 min突发全面性遗忘，无视力丧失、头痛、精神错乱、癫痫发作、偏瘫、失语、昏迷等其他临床表现。神经系统查体未发现明显阳性体征。急查头颅CT及头颅磁共振成像联合磁共振血管成像均未见缺血性或出血性脑卒中特征性影像。考虑碘对比剂脑病，予地塞米松、依达拉奉、甘露醇及水化治疗，约18 h后患者记忆完全恢复。碘对比剂脑病是一种罕见的并发症，表现为短暂性全面性遗忘的病例更为罕见，鲜有报道。临床医师使用碘对比剂时应警惕诱发脑病的可能性，以防误诊为急性脑卒中导致不必要地额外使用对比剂行进一步检查及侵入性或非侵入性干预。
关键词(KeyWords)： 碘对比剂脑病;短暂性全面性遗忘;心导管术
基金项目(Foundation): 深圳市医学重点学科（SZXK001）
作者(Author): 陈怡粤,邓鸣,房子熙,余小平
参考文献(References)：
- [1] Liu MR, Jiang H, Li XL, et al. Case report and literature review on low-osmolar, non-ionic iodine-based contrast-induced encephalopathy[J]. Clin Interv Aging, 2020,15:2277-2289. DOI:10.2147/CIA.S280931.
- [3] Dattani A, Au L, Tay KH, et al. Contrast-induced encephalopathy following coronary angiography with no radiological features:a case report and literature review[J]. Cardiology, 2018, 139(3):197-201. DOI:10.1159/000486636.
- [3] Spina R, Simon N, Markus R, et al.Contrast-induced encephalopathy following cardiac catheterization[J]. Catheter Cardiovasc Interv, 2017, 90(2):257-268. DOI:10.1002/ccd.26871.
- [4] Park JC, Ahn JH, Chang IB, et al. A case of unusual presentation of contrast-induced encephalopathy after cerebral angiography using iodixanol[J]. J Cerebrovasc Endovasc Neurosurg, 2017, 19(3):184-188. DOI:10.7461/jcen.2017.19.3.184.
- [5] Torvik A, Walday P. Neurotoxicity of water-soluble contrast media[J]. Acta Radiol Suppl,1995,399:221-229. DOI:10.1177/0284185195036s39927.
- [6] Li M, Liang H, Liu C,et al. Risk factors of transient cortical blindness after cerebral angiography:a multicenter study[J]. Front Neurol, 2019,10:1005. DOI:10.3389/fneur.2019.01005.
- [7] Yildiz A, Yencilek E, Apaydin FD, et al. Transient partial amnesia complicating cardiac and peripheral arteriography with nonionic contrast medium[J]. Eur Radiol, 2003,13 Suppl 4:L113-L115.DOI:10.1007/s00330-003-1975-8.
- [8] Fisher CM. Transient global amnesia. Precipitating activities and other observations[J]. Arch Neurol, 1982,39(10):605-608. DOI:10.1001/archneur.1982.00510220003001.
- [9] Tong DC, Grossman M. What causes transient global amnesia? New insights from DWI[J]. Neurology, 2004,62(12):2154-2155. DOI:10.1212/01.wnl.0000132256.64800.cb.