Acute Transient Cortical Blindness Due to Seizure Following Cerebral Angiography

OBJECTIVE: Transient cortical blindness (TCB) is reported as a rare complication of coronary and cerebral angiography. Angiography of the vertebral arteries carries the highest incidence of causing TCB. The etiology of this phenomenon is unknown. CLINICAL PRESENTATION: A 42-year-old woman underwent treatment for an enlarging pseudoaneurysm of her vertebral artery. The patient had a brief complex seizure during angiography. Following the procedure, she experienced TCB. During this time, an electroencephalogram (EEG) showed seizure activity. This case represents the first recorded instance of abnormal EEG during angiography-associated TCB. INTERVENTION: The patient was immediately given intravenous lorazepam and phenytoin sodium. Her EEG returned to normal in the ensuing hours and subsequently her vision returned to normal. CONCLUSION: We present the first reported case of abnormal EEG activity during angiography-associated TCB. We hypothesize that seizure activity is a possible underlying cause of angiography-induced TCB.