Diffuse Fluid-Attenuated Inversion Recovery Hyperintensity in Subarachnoid Space Following Cerebral Angiography and Intravenous Thrombolysis

J Stroke Cerebrovasc Dis. 2015 Dec;24(12):e1-3. doi: 10.1016/j.jstrokecerebrovasdis.2015.08.021. Epub 2015 Oct 21.

Abstract

Objective: Transient cortical blindness (TCB) is a relatively rare but well-recognized complication following cardiovascular and cerebral angiography.

Methods: A 68-year-old male developed TCB following cerebral angiography along with punctate diffusion lesion evident on emergent magnetic resonance imaging (MRI). The patient received intravenous tissue plasminogen activator (IV-tPA) for suspected stroke.

Results: Follow-up MRI revealed diffuse hyperintensities in subarachnoid space in fluid-attenuated inversion recovery (FLAIR) sequence mostly in bilateral occipital lobes.

Conclusion: The finding on the FLAIR as described in this case is an indication of diffuse disruption of the blood-brain barrier perhaps secondary to cerebral angiography, high blood pressure, and IV-tPA. To the best of our knowledge, this is the first reported case of TCB with diffuse postcontrast FLAIR changes.

Keywords: Cortical; angiography; blindness; magnetic resonance imaging.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Blindness / etiology*
  • Blindness / pathology
  • Blood-Brain Barrier / pathology*
  • Cerebral Angiography / adverse effects*
  • Fibrinolytic Agents / adverse effects*
  • Fibrinolytic Agents / therapeutic use
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Subarachnoid Space / pathology*
  • Thrombolytic Therapy / adverse effects*
  • Tissue Plasminogen Activator / adverse effects*
  • Tissue Plasminogen Activator / therapeutic use

Substances

  • Fibrinolytic Agents
  • PLAT protein, human
  • Tissue Plasminogen Activator