iothalamate-meglumine and Cerebral-Infarction

A 64-year-old man developed lethargy and aphasia immediately following cerebral arteriography with iothalamate meglumine. An electroencephalogram showed continuous epileptiform activity. The patient was treated with intravenous phenytoin with complete resolution of clinical symptoms and electroencephalographic epileptiform abnormalities. The diagnosis of nonconvulsive status epilepticus should be considered in cases of altered consciousness following cerebral arteriography.

Topics: Cerebral Angiography; Cerebral Infarction; Delta Rhythm; Electroencephalography; Humans; Iothalamate Meglumine; Male; Middle Aged; Occipital Lobe; Status Epilepticus; Temporal Lobe

An important computerized tomographic (CT) pattern is described, in which selective enhancement of cerebral gray matter occurs after intravenous administration of contrast medium. Analysis of 76 cases displaying the enhancement pattern revealed that the phenomenon occurs in diseases characterized by hypoxia, and may be attributed to regional vascular dysautoregulation. Eighty percent of these patients had primary cerebrovascular disease (infarctions or transient ischemic attacks); 20% with other disorders also had evidence of cerebral ischemia or infarction. When hypoxia progressed to infarction, the enhancement was accompanied by one or more parenchymal areas of decreased density. However, in transient ischemic attacks, it occurred without other parenchymal abnormality and represents the first recognized CT sign of cerebral hypoxia. Enhancement was observed within 3 weeks of onset in 80% of cases, but in 20% it persisted for up to 4 months, indicating a protracted state of dysautoregulation.

Topics: Adolescent; Aged; Brain; Cerebral Infarction; Cerebrovascular Disorders; Female; Humans; Hypoxia, Brain; Intracranial Aneurysm; Intracranial Arteriovenous Malformations; Iothalamate Meglumine; Ischemic Attack, Transient; Male; Middle Aged; Tomography, X-Ray Computed

Topics: Adult; Aged; Brain Neoplasms; Cerebral Infarction; Contrast Media; Diagnosis, Differential; Female; Humans; Iothalamate Meglumine; Male; Middle Aged; Radiographic Image Enhancement; Time Factors; Tomography, X-Ray Computed