Contrast-induced encephalopathy in an infant

Abstract

Contrast-induced encephalopathy (CIE) is a well-known but rare complication following contrast media administration. Its nonspecific clinical manifestations hinder diagnosis, particularly in the pediatric population. The majority of cases are reversible, with clinical improvement and resolution of signs noted on diagnostic imaging. Here, we report the case of a 2-month-old patient with a history of complex cardiovascular disease who presented with a single episode of seizure after undergoing cardiac catheterization with nonionic iodinated contrast media. CIE is diagnosed based on the signs and symptoms exhibited by the patient and the findings on plain head computed tomography (CT) scan. Subsequently, the absence of neurological symptoms and disappearance of the imaging alterations on a control CT are documented.

Keywords: Blood–brain barrier; Contrast medium; Encephalopathy; Neurotoxicity.

Fig. 1

Initial noncontrast head tomography, after cardiac catheterization. (A-C) Axial cuts from cranial to caudal. Slight diffuse increase in the density of predominantly frontal, parietal and occipital cortices in the right cerebral hemisphere, and to a lesser extent in the left parietal and occipital lobe. No expansive lesions or signs suggestive of a mass effect are observed.

Fig. 2

Control noncontrast head tomography, 11 days after cardiac catheterization. (A-C) Axial cuts from cranial to caudal. Absence of diffuse hyperdensity evidenced in the previous skull tomography