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Background: Contrast-induced neurotoxicity (CIN) is an increasingly observed event following the administration of iodinated contrast. It presents as a spectrum of neurological symptoms that closely mimic ischaemic stroke, however, CIN remains a poorly understood clinical phenomenon. An appreciation of the underlying pathophysiological mechanisms is essential to improve clinical understanding and enhance decision-making.
Methods: A broad literature search of Medline (1946 to December 2022) and Embase (1947 to December 2022) was conducted. Articles discussing the pathophysiology of CIN were reviewed.
Summary: The pathogenesis of CIN appears to be multifactorial. A key step is likely blood-brain barrier (BBB) breakdown due to factors including ischaemic stroke, uncontrolled hypertension, and possibly contrast agents themselves, among others. This is followed by passage of contrast agents across the BBB, leading to chemotoxic sequelae on neural tissue.
Key Messages: This review provides a clinically oriented review on the pathophysiology of CIN to enhance knowledge and improve decision-making among clinicians.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11003557 | PMC |
http://dx.doi.org/10.1159/000535928 | DOI Listing |
Surg Neurol Int
May 2025
Department of Neurosurgery, Brain Research Institute, University of Niigata, Niigata, Japan.
Background: Contrast-induced encephalopathy (CIE) is a rare complication arising from neurotoxicity caused by iodinated contrast agents. Its clinical presentation closely resembles that of acute stroke, which can occur following endovascular procedures. Distinguishing these two conditions is essential for proper patient management but is challenging based on clinical symptoms alone.
View Article and Find Full Text PDFObjective: To present a case of encephalopathy after the administration of an iodinated contrast medium in a coronary angiography procedure.
Case Summary: A 75-year-old male heart transplant recipient with cardiac allograft vasculopathy underwent coronary angiography followed by percutaneous coronary intervention. An iodinated contrast medium, ioversol, was used.
Neuroradiology
May 2025
Department of Neuroradiology, University Hospital Bonn, Bonn, Germany.
Purpose: Contrast-induced encephalopathy (CIE) is a rare but increasingly recognized complication following therapeutic and diagnostic endovascular neurointerventions, including mechanical thrombectomy (MT). This study aimed to investigate the incidence, imaging characteristics, and risk factors of CIE, utilizing flat-detector (FD) CT for immediate post-interventional assessment.
Methods: We retrospectively evaluated patients who underwent MT for acute ischemic stroke (AIS) between January 2020 and February 2023, who received FDCT directly after the intervention.
Neuroradiology
May 2025
Monash University, Melbourne , Australia.
Introduction: Contrast-induced encephalopathy (CIE) is a recognised complication of contrast administration, however diagnosis remains challenging due to its symptom overlap with other neurological conditions and the absence of formal diagnostic criteria.
Methods: A modified Delphi study was performed. Consultant physicians with active clinical experience with CIE patients were invited from neurovascular centres in Australia.