表现为短暂性全面性遗忘的心脏造影术后碘对比剂脑病1例  

A case of contrast-induced encephalopathy with transient global amnesia after cardiac catheterization CHEN Yi-yue,DENG Ming,FANG Zi-xi,YU Xiao-ping.Department of Cardiology,Fuwai Hospital Chinese Academy of Medical Sciences,Shenzhen 518057,China

作　　者：陈怡粤 邓鸣 房子熙 余小平 CHEN Yi-yue;DENG Ming;FANG Zi-xi;YU Xiao-ping(Department of Cardiology,Fuwai Hospital Chinese Academy of Medical Sciences,Shenzhen 518057,China)

机构地区：[1]中国医学科学院阜外医院深圳医院冠心病中心,广东深圳518057

出　　处：《中国介入心脏病学杂志》2023年第5期398-400,共3页Chinese Journal of Interventional Cardiology

基　　金：深圳市医学重点学科(SZXK001)。

摘　　要：报道1例冠心病合并肥厚型心肌病患者行冠状动脉造影及左心室造影术后40 min突发全面性遗忘,无视力丧失、头痛、精神错乱、癫痫发作、偏瘫、失语、昏迷等其他临床表现。神经系统查体未发现明显阳性体征。急查头颅CT及头颅磁共振成像联合磁共振血管成像均未见缺血性或出血性脑卒中特征性影像。考虑碘对比剂脑病,予地塞米松、依达拉奉、甘露醇及水化治疗,约18 h后患者记忆完全恢复。碘对比剂脑病是一种罕见的并发症,表现为短暂性全面性遗忘的病例更为罕见,鲜有报道。临床医师使用碘对比剂时应警惕诱发脑病的可能性,以防误诊为急性脑卒中导致不必要地额外使用对比剂行进一步检查及侵入性或非侵入性干预。A patient with coronary heart disease combined with hypertrophic cardiomyopathy was reported to have sudden total amnesia 40 min after coronary angiography and left ventriculography,without visual loss,headache,confusion,seizures,hemiplegia,aphasia,coma or other clinical manifestations.No significant positive signs were found in neurological examination.No characteristic images of ischemic or hemorrhagic stroke were found in cranial CT and cranial magnetic resonance imaging combined with magnetic resonance angiography.Considering iodine contrast encephalopathy,the patient was treated with dexamethasone,Edaravone,mannitol and hydration,and the memory was completely recovered about 18 h later.Contrast-induced encephalopathy was a rare complication,and transient global amnesia was rarely reported.Clinicians should be alert to the possibility of inducing encephalopathy when using iodine contrast agents to prevent misdiagnosis of acute stroke and unnecessary additional use of contrast agents for further examination and invasive or non-invasive intervention.

关 键 词：碘对比剂脑病 短暂性全面性遗忘 心导管术 

分 类 号：R541.4[医药卫生—心血管疾病]