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Cerebral contrast retention after difficult cardiac catheterization: Case report

BACKGROUND: We report a diagnostic dilemma in a rare case of cerebral contrast retention after difficult cardiac catheterization in an elderly patient loaded with prasugrel. SUMMARY: Our case report describes a 77-year-old female with history of hypertension, diabetes, and dyslipidemia who presented...

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Autores principales: Khan, Shahid M, Ho, David W, Lazar, Jason M, Marmur, JD
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4857345/
https://www.ncbi.nlm.nih.gov/pubmed/27489644
http://dx.doi.org/10.1177/2050313X14530283
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author Khan, Shahid M
Ho, David W
Lazar, Jason M
Marmur, JD
author_facet Khan, Shahid M
Ho, David W
Lazar, Jason M
Marmur, JD
author_sort Khan, Shahid M
collection PubMed
description BACKGROUND: We report a diagnostic dilemma in a rare case of cerebral contrast retention after difficult cardiac catheterization in an elderly patient loaded with prasugrel. SUMMARY: Our case report describes a 77-year-old female with history of hypertension, diabetes, and dyslipidemia who presented to emergency department complaining of chest pain. Patient was found to have an inferior wall ST elevation myocardial infarction. The patient was loaded with aspirin and prasugrel and taken for emergent cardiac catheterization. Cardiac catheterization revealed two-vessel coronary artery disease with unsuccessful attempt of percutaneous intervention. Immediately after procedure, patient developed an episode of seizure. Emergent computed tomography scan of the brain revealed hyperdensity in the right frontoparietal region consistent with intracerebral bleed. Repeat computed tomography (24 h later) revealed substantial interval improvement of hyperdensity. Follow-up magnetic resonance imaging of the head was normal. Given the lack of magnetic resonance imaging changes, the rate of resolution on computed tomography without expected subacute changes, and the lack of neurologic findings, the initial hyperdensity seen on computed tomography of the brain was believed to be secondary to contrast leakage during cardiac catheterization as opposed to intracranial hemorrhage.
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spelling pubmed-48573452016-08-03 Cerebral contrast retention after difficult cardiac catheterization: Case report Khan, Shahid M Ho, David W Lazar, Jason M Marmur, JD SAGE Open Med Case Rep Case Report BACKGROUND: We report a diagnostic dilemma in a rare case of cerebral contrast retention after difficult cardiac catheterization in an elderly patient loaded with prasugrel. SUMMARY: Our case report describes a 77-year-old female with history of hypertension, diabetes, and dyslipidemia who presented to emergency department complaining of chest pain. Patient was found to have an inferior wall ST elevation myocardial infarction. The patient was loaded with aspirin and prasugrel and taken for emergent cardiac catheterization. Cardiac catheterization revealed two-vessel coronary artery disease with unsuccessful attempt of percutaneous intervention. Immediately after procedure, patient developed an episode of seizure. Emergent computed tomography scan of the brain revealed hyperdensity in the right frontoparietal region consistent with intracerebral bleed. Repeat computed tomography (24 h later) revealed substantial interval improvement of hyperdensity. Follow-up magnetic resonance imaging of the head was normal. Given the lack of magnetic resonance imaging changes, the rate of resolution on computed tomography without expected subacute changes, and the lack of neurologic findings, the initial hyperdensity seen on computed tomography of the brain was believed to be secondary to contrast leakage during cardiac catheterization as opposed to intracranial hemorrhage. SAGE Publications 2014-04-07 /pmc/articles/PMC4857345/ /pubmed/27489644 http://dx.doi.org/10.1177/2050313X14530283 Text en © The Author(s) 2014 This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License (http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page(http://www.uk.sagepub.com/aboutus/openaccess.htm).
spellingShingle Case Report
Khan, Shahid M
Ho, David W
Lazar, Jason M
Marmur, JD
Cerebral contrast retention after difficult cardiac catheterization: Case report
title Cerebral contrast retention after difficult cardiac catheterization: Case report
title_full Cerebral contrast retention after difficult cardiac catheterization: Case report
title_fullStr Cerebral contrast retention after difficult cardiac catheterization: Case report
title_full_unstemmed Cerebral contrast retention after difficult cardiac catheterization: Case report
title_short Cerebral contrast retention after difficult cardiac catheterization: Case report
title_sort cerebral contrast retention after difficult cardiac catheterization: case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4857345/
https://www.ncbi.nlm.nih.gov/pubmed/27489644
http://dx.doi.org/10.1177/2050313X14530283
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