Kantonsspital St.Gallen

Transient Cortical Blindness: a Rare Complication After Cerebral Digital Substraction Angiography

Andreas Weiss, Jürgen Den Hollander & Urs Pietsch

abstract Transient cortical blindness (TCB) is a rare complication after cerebral or coronary angiography. In this article, we elaborate the
condition and present a case which occurred in our hospital. With increasing numbers of diagnostic angiographies and
endovascular interventions, we want to raise awareness of TCB and its clinical course. We report about a 57-year-old woman
with TCB after a diagnostic digital subtraction angiography (DSA) and endovascular treatment of a ruptured aneurysm of the
basilar tip. Symptoms disappeared spontaneously after 36 h with no residual deficits. Multimodal imaging including non-contrast
enhanced cerebral CT-scan (NECT), cerebral magnetic resonance imaging (cMRI), and cerebral DSA are presented. Despite the
seemingly grave event, the prognosis of this condition can be considered as excellent. The exact pathophysiology remains
speculative, but might be related to contrast agent neurotoxicity with transient disruption of blood brain barrier integrity.
Immediate computed tomographic angiogram (CTA) and CT-scan or magnetic resonance angiography (MRA) and cMRI should
be performed after an occurrence of a suspected TCB to rule out embolic occlusions or hemorrhage. The administration of
steroids can be considered.
keywords TCB . Transient cortical blindness . Angiography . Contrast agent
citation Weiss A, Den Hollander J, Pietsch U. Transient Cortical Blindness: a Rare Complication After Cerebral Digital Substraction Angiography. SN Comprehensive Clinical Medicine 2019; 1:567-570.
type journal paper/review (English)
date of publishing 17-6-2019
journal title SN Comprehensive Clinical Medicine (1/8)
publisher Springer Nature Switzerland AG (Basel)
ISSN electronic 2523-8973
pages 567-570
DOI 10.1007/s42399-019-00093-2
link https://doi.org/10.1007/s42399-019-00093-2
contact Jürgen den Hollander