Cerebral contrast medium extravasation after coronary angiography

We report on an 82-year-old woman who suffered a sudden loss of consciousness, right-side hemiparesis,and aphasia during a coronary an giographic procedure. Computed tomography (CT) of the brain performed immediately revealed an edema and extravascularly localized contrast media in the left hemisphere. Within 6 h, neurological symptoms had disappeared,and a second CT after 48 h revealed normal results. Usually, extravasation of contrast media affects the posterior circulation with cortical blindness. This case demonstrates that contrast media, may affect the blood-brain barrier also outside-the posterior circulation. If neurological symptoms occur during angiography, contrast media extravasation must be distinguished from embolism or vasospasm induced by the angiographic procedure.