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Transient Cortical Blindness Following Bypass Graft Angiography

A Case Report

Second Department of Internal Medicine, Iwate Medical University

Kenichi Fukami

Second Department of Internal Medicine, Iwate Medical University

Hiroaki Yoshida

Second Department of Internal Medicine, Iwate Medical University

Yoshimi Mizunuma

Second Department of Internal Medicine, Iwate Medical University

Naoki Moriai

Second Department of Internal Medicine, Iwate Medical University

Toshitake Takino

Second Department of Internal Medicine, Iwate Medical University

Shunichi Hosokawa

Second Department of Internal Medicine, Iwate Medical University

Koya Hashimoto

Second Department of Internal Medicine, Iwate Medical University

Kenji Nakai

Second Department of Internal Medicine, Iwate Medical University

Kohei Kawazoe

Third Department of Surgery, Iwate Medical University, Morioka, Japan

Katsuhiko Hiramori

Second Department of Internal Medicine, Iwate Medical University

Transient cortical blindness, an uncommonly recognized complication of cerebral angiog raphy, is an exceedingly rare event after cardiac catheterization and angiography. This report describes a sixty-two-year-old patient who had transient cortical blindness following bypass graft angiography. In this case, the authors showed that cortical blindness was associated with the breakage of the blood-brain barrier (BBB) and an increase in vascular permeability rather than with primary cerebral circulatory insuffi ciency. When the possibility exists that an excess volume of contrast medium may enter the cerebral circulation as in this case, that is, following a coronary artery bypass graft (CABG) using the internal mammary artery (IMA), precautionary measures may be necessary such as changing the type of contrast medium to be used or decreasing the volume injected. When cortical blindness occurs, it is a serious clinical problem whether transient or permanent. Therefore, the circumstances leading to this complication should be understood to determine suitable treatment and management.

Angiology, Vol. 46, No. 10, 937-946 (1995)
DOI: 10.1177/000331979504601009


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