Transient cortical blindness is rarely encountered after angiography of native coronary arteries or bypass grafts. This paper reports a case of transient cortical blindness that occurred 72 h after coronary angiography in a 56-year old patient. This was the patient's fourth exposure to contrast medium. Neurological examination demonstrated cortical blindness and the absence of any focal neurological deficit. A non-contrast-enhanced computed tomographic scan of the brain revealed bilateral contrast enhancement in the occipital lobes and no evidence of cerebral haemorrhage, and magnetic resonance imaging of the brain showed no pathology. Sight returned spontaneously within 4 days and his vision gradually improved. A search of the current literature for reported cases of transient cortical blindness suggested that this is a rarely encountered complication of coronary angiography.
AntonellisJKostopoulosKRambaouniA: Cortical blindness following coronary arteriography: A rare but self-cured complication. Two case reports. Angiology1996; 47: 803–806.
7.
VranckxPYsewijnTWilmsG: Acute posterior cerebral circulation syndrome accompanied by serious cardiac rhythm disturbances: A rare but reversible complication following bypass graft angiography. Catheter Cardiovasc Interv1999; 48: 397–401.
8.
KwokBWKLimTT: Cortical blindness following coronary angiography. Singapore Med J2000; 41: 604–605.
9.
GellenBRempTMayerT: Cortical blindness: A rare but dramatic complication following coronary angiography. Cardiology2003; 99: 57–59.
10.
DanenbergHDLotanC: Nonrecurring transient cortical blindness after coronary angiography: A role for hypoventilation and hypercarbia?Catheter Cardiovasc Interv2006; 67: 384–385.
11.
ZwickerJCSilaCA: MRI findings in a case of transient cortical blindness after cardiac catheterization. Catheter Cardiovasc Interv2002; 57: 47–49.
12.
YaziciMOzhanHKinayO: Transient cortical blindness after cardiac catheterization with Iobitridol. Tex Heart Inst J2007; 34: 373–375.
13.
LimKKRadfordDJ: Transient cortical blindness related to coronary angiography and graft study. Med J Aust2002; 177: 43–44.
14.
HenzlovaMJCoghlanHCDeanLS: Cortical blindness after left internal mammary artery to left anterior descending coronary artery graft angiography. Cathet Cardiovasc Diagn1988; 15: 37–39.
15.
de BonoD: Complications of diagnostic cardiac catheterisation: Results from 34,041 patients in the United Kingdom confidential enquiry into cardiac catheterization complications. Br Heart J1993; 70: 297–300.
16.
TatliEBuyukluMAltunA: An unusual but dramatic complication of coronary angiography: Transient cortical blindness. Int J Cardiol2007; 121: e4–e6.
17.
BorghiCSaiaFMarzocchiA: The conundrum of transient cortical blindness following coronary angiography. J Cardiovasc Med (Hagerstown)2008; 9: 1063–1065.
LantosG: Cortical blindness due to osmotic disruption of the blood–brain barrier by angiographic contrast material: CT and MRI studies. Neurology1989; 39: 567–571.
21.
SaigalGBhatiaRBhatiaS: MR findings of cortical blindness following cerebral angiography: Is this entity related to posterior reversible leukoencephalopathy?AJNR Am J Neuroradiol2004; 25: 252–256.
22.
MathRSSinghSBahlV: An uncommon complication after a common procedure. J Invasive Cardiol2008; 20: E301–E303.
23.
DemirtasMBirandAUsalA: Transient cortical blindness after second coronary angiography: Is immunological mechanism possible?Cathet Cardiovasc Diagn1994; 31: 161.
24.
LundCNesRBUgelstadTP: Cerebral emboli during left heart catheterization may cause acute brain injury. Eur Heart J2005; 26: 1269–1275.
25.
HamonMGomesSClergeauMR: Risk of acute brain injury related to cerebral micro embolism during cardiac catheterization performed by right upper limb arterial access. Stroke2007; 38: 2176–2179.
StanimirovicDBBertrandNMcCarronR: Arachidonic acid release and permeability changes induced by endothelins in human cerebromicrovascular endothelium. Acta Neurochir1994; 60: 71–75.
28.
AlbayramSOzerH: MR imaging findings of cortical blindness following cerebral angiography: Is this entity related to posterior reversible leukoencephalopathy?AJNR Am J Neuroradiol2005; 26: 193.
