J Neurol Neurosurg Psychiatry 84:458-459 doi:10.1136/jnnp-2012-303923
  • Neurological picture

Neurotoxic cerebral oedema following coronary angiography

  1. Steffen Naegel1
  1. 1Department of Neurology, University of Duisburg-Essen, Essen, Germany
  2. 2Department of Neurology, Institute for Diagnostic and Interventional Radiology and Neuroradiology, University of Duisburg-Essen, Essen, Germany
  1. Correspondence to  Dr Mark Obermann, Department of Neurology, University of Duisburg-Essen, Hufelandstr. 55 Essen 45122, Germany; mark.obermann{at}
  • Received 15 August 2012
  • Revised 5 October 2012
  • Accepted 9 October 2012
  • Published Online First 8 November 2012

Case description

A 60-year-old woman was found unconscious in her hospital bed approximately 2 h after routine coronary angiography. Glasgow coma scale was 6, she was intubated immediately and transferred to the intensive care unit. Cerebral computer tomography (CCT) showed unilateral cerebral oedema of the entire right hemisphere without signs of cerebral ischaemia or haemorrhage (figure 1A). No signs of brainstem affection or herniation was seen on initial CCT, but a slight midline shift was present. Neurological examination revealed left-sided hemiplegia and positive Babinski's sign of her left foot. The initial coronary catheterisation was performed as routine diagnostic procedure to assess the extent of suspected coronary artery disease following an observed T wave inversion in the ECG, which turned out to be mild and non-stenotic. During the procedure, no …

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