OJMN  Vol.4 No.3 , July 2014
Cerebral Angiography Induced Prolonged Focal Seizure and Hemiparesis during Carotid Artery Balloon Test Occlusion
Abstract: The frequency of neurologic complications of cerebral angiography is 0.3%-2.3%, and the frequency of the persistent neurologic deficits that remain over 7-10 days is 0.4%-0.5%. On the other hand, all neurologic complications of balloon test occlusion (BTO) have been reported in 0%-8.3% and especially in 1.6%-1.7% of symptomatic neurologic complications. There are a few reports concerning a seizure related to cerebral angiography and BTO. We report a case of prolonged seizures and left hemiparesis during and after BTO of the right internal carotid artery. The patient showed repeated focal seizures and prolonged left hemiparesis lasting for approximately 2 months. Computed tomography and magnetic resonance imaging demonstrated no abnormal findings. Suspected mechanisms of seizure were a cerebral blood flow change induced by BTO and neurotoxicity of accumulated contrast medium. A combination of prolonged focal seizures and subsequent hemiparesis is a rare complication of BTO, which should be taken into consideration during BTO.
Cite this paper: Kato, Y. , Sorimach, T. , Ito, Y. , Fujii, Y. and Kawahara, N. (2014) Cerebral Angiography Induced Prolonged Focal Seizure and Hemiparesis during Carotid Artery Balloon Test Occlusion. Open Journal of Modern Neurosurgery, 4, 126-130. doi: 10.4236/ojmn.2014.43022.

[1]   Leffers, A.M. and Wagner, A. (2000) Neurologic Complications of Cerebral Angiography. Acta Radiologica, 41, 204- 210.

[2]   Willinsky. R.A., Taylor, S.M., TerBrugge. K., Farb, R.I., Tomlinson, G. and Montanera, W. (2003) Neurologic Complications of Cerebral Angiography: Prospective Analysis of 2,899 Procedures and Review of the Literature. Neuroradiology, 22, 522-528.

[3]   Mathis, J.M., Barr, J.D., Jungreis, C.A., Yonas, H., Sekhar, L.N., Vincent, D., Pentheny, S.L. and Horton, J.A. (1995) Temporary Balloon Test Occlusion of the Internal Carotid Artery: Experience in 500 Cases. American Journal of Neuroradiology, 16, 749-754.

[4]   Tarr, R.W., Jungreis, C.A., Horton, J.A., Petheny, S., Sekhar, L.N., Sen, C., Janecka, I.P. and Yonas, H. (1991) Complications of Preoperative Balloon Test Occlusion of the Internal Carotid Arteries: Experience in 300 Cases. Skull Base Surgery, 1, 240-244.

[5]   Mitsuyama, T., Sato, S., Ishii, A. and Kawamata, T. (2010) Contrast Medium-Induced Seizures and Prolonged Motor Weakness after Cerebral Angiography: Case Report. Neurosurgery, 67, 1460-1463.

[6]   Mutoh, T., Ishikawa, T., Sawada, M., Moroi, J., Tamakawa, N., Hikichi, K., Suzuki, A. and Yasui, N. (2010) Cerebral Complications Induced by Neurotoxity of Nonionic Contrast Medium after Embolization of Unruptured Cerebral Aneurysms: Report of 2 Cases. No Shinkei Geka, 38, 163-170.

[7]   Haraguchi, K., Houkin, K., Koyanagi, I., Nonaka, T. and Baba, T. (2009) Reversible Hyperintense Lesion after Balloon Occlusion Test. Journal of Neuroimaging, 19, 174-178.

[8]   Ozturk, A., Saatci, I., Pamuk, A.G., Erdogan, C., Akmangit, I., Geyik, S. and Cekirge, H.S. (2006) Focal Increased Cortical Density in Immediate Postembolization CT Scans of Patients with Intracranial Aneurysms. American Journal of Neuroradiology, 27, 1866-1875.

[9]   McClennan, B.L. (1990) Ionic and Nonionic Iodinated Contrast Media: Evolution and Strategies for Use. American Journal of Roentgenology, 155, 225-233.

[10]   Nelson, M., Bartlett, R.J. and Lamb, J.T. (1989) Seizure after Intravenous Contrast Media for Cranial Computed Tomography. Journal of Neurology, Neurosurgery and Psychiatry, 52, 1170-1175.