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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 …
Contributors MO: acquisition of data, patient treatment, drafting the manuscript. SN: interpretation of data, patient treatment, revising the manuscript. CM-H: evaluation of images.
Competing interests Dr Obermann has received scientific support and/or honoraria from Biogen Idec, Novartis, Sanofi-Aventis, Pfizer and Teva. He received research grants from the German Ministry for Education and Research (BMBF).
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.