Key result
Transient cortical blindness after bypass angiography is linked to blood-brain barrier breakdown, not circulatory insufficiency.
Case Report (n=1)
Transient cortical blindness is a rare but serious complication of bypass graft angiography, particularly when injecting contrast into the internal mammary artery, and appears to be associated with blood-brain barrier breakdown.
May suggest blood-brain barrier disruption in post-angiography cortical blindness; leaves open need for validation beyond this single case.
Transient cortical blindness, an uncommonly recognized complication of cerebral angiography, 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 insufficiency. 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.
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Kamata et al. (1995) conducted a case report in Transient cortical blindness (n=1). Bypass graft angiography with contrast medium was evaluated on Transient cortical blindness. Transient cortical blindness following bypass graft angiography was associated with blood-brain barrier breakage and increased vascular permeability rather than primary cerebral circulatory insufficiency.
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