Diagnostic and Therapeutic Dilemmas in Acute Stroke With Contrast Allergy: A Case Report

Contrast allergy in acute stroke presents a significant challenge, as many aspects of management require the use of iodinated contrast agents. In patients with known contrast allergy, standard imaging techniques may be contraindicated. This case presents a woman in her 70s who developed right-sided facial droop, weakness, and slurred speech. Initial CT head imaging showed a likely hyperdense left middle cerebral artery, and she was thrombolyzed. However, CT angiography was not performed due to severe contrast allergy, limiting further mechanical thrombectomy if required. This case highlights the need for specialized management strategies for patients with contrast allergy in acute stroke and emphasizes the importance of timely decision-making in stroke management.