Acute Neurological Deficits Post Coronary Angiography: A Case Report of Contrast Induced Neurotoxicity and Its Clinical Implications

Abstract

Introduction: This case report aims to highlight contrast-induced neurotoxicity as a rare but increasingly recognized complication of coronary angiography. Neurological side effects from iodinated contrast agents are rare but increasingly reported, particularly in cardiovascular imaging. Case Presentation: We report a case involving a 51-year-old woman who experienced acute neurological deficits, including incontinence and flaccid quadriplegia, within 30 minutes of undergoing elective coronary angiography, despite being fully oriented. Brain MRI and angiography revealed no acute lesions or obstructions, suggesting contrast-induced neurotoxicity (CIN). The patient received conservative management with intravenous hydration and hydrocortisone, leading to a full recovery within 48 hours. She was discharged in good condition and remained symptom-free at follow-up visits for one month, six months, and a year post-discharge. Conclusions: This case underscores the importance of recognizing CIN as a potential complication of contrast use in imaging procedures. Our literature review highlights the current understanding of CIN mechanisms, typically involving disruption of the blood-brain barrier, and emphasizes that supportive care remains the cornerstone of treatment. Although rare, this occurrence draws attention to the neurological complications that can arise from contrast media, underscoring the need for vigilance and supportive care in post-procedure monitoring. Further clinical studies are crucial to elucidate the pathophysiology of CIN and improve management strategies. Although case reports have limitations in generalizability, this detailed description contributes valuable insights into the presentation and management of CIN, informing future research and clinical practice.