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Background: We report a case of contrast-induced encephalopathy (CIE) following coil embolization of a ruptured anterior communicating artery (AComA) aneurysm with bilateral A1 segment development. The aneurysm was visualized by forcefully injecting contrast medium from a distal access catheter (DAC) positioned distally in the internal carotid artery (ICA).

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Objective: Contrast-induced encephalopathy (CIE) is a rare complication of endovascular procedures with an incompletely understood pathophysiology. Its intraoperative detection under general anesthesia can be challenging. We present a case of CIE occurring during aneurysm embolization, demonstrating varying severity across procedures and suggesting that somatosensory evoked potentials (SEPs) may help in early recognition.

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