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Transient Cortical Blindness: a Rare Complication After Cerebral Digital Substraction Angiography
Wissenschaftlicher Artikel/Review - 17.06.2019
Weiss Andreas, Den Hollander Jürgen, Pietsch Urs
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Transient cortical blindness (TCB) is a rare complication after cerebral or coronary angiography. In this article, we elaborate the
condition and present a case which occurred in our hospital. With increasing numbers of diagnostic angiographies and
endovascular interventions, we want to raise awareness of TCB and its clinical course. We report about a 57-year-old woman
with TCB after a diagnostic digital subtraction angiography (DSA) and endovascular treatment of a ruptured aneurysm of the
basilar tip. Symptoms disappeared spontaneously after 36 h with no residual deficits. Multimodal imaging including non-contrast
enhanced cerebral CT-scan (NECT), cerebral magnetic resonance imaging (cMRI), and cerebral DSA are presented. Despite the
seemingly grave event, the prognosis of this condition can be considered as excellent. The exact pathophysiology remains
speculative, but might be related to contrast agent neurotoxicity with transient disruption of blood brain barrier integrity.
Immediate computed tomographic angiogram (CTA) and CT-scan or magnetic resonance angiography (MRA) and cMRI should
be performed after an occurrence of a suspected TCB to rule out embolic occlusions or hemorrhage. The administration of
steroids can be considered.