Abdullah ERDEM, Celal AKDENİZ, Ender ÖDEMİŞ, Ahmet ÇELEBİ

A Rare Complication of Diagnostic Angiography in a Child with Vertebro-Venous Fistula: Transient Total Cortical Blindness

Transient cortical blindness is a rare and dramatic complication after coronary angiocardiography in adulthood. This potential complication of transcatheter procedures which are widely used in the diagnosis and treatment of congential heart disease has not been reported during childhood. Although the exact mechanism is not fully understood, the direct idiosyncratic neurotoxicity is the most reasonable explanation. In this manuscript, we present a nine-year-old child who developed transient cortical blindness following diagnostic angiography with vertebro- venous fistula (VVF) which might be the cause of this complication. In regard to this case, the pathogenetic mechanisms and management of this rare complication were also discussed.

Keywords:

Angiography, transient total cortical blindness, child,

PDF

___

Parry R, Rees JR, Wilde P. Transient cortical bilndness after coro- nary anigography. Br Heart J 1993;70:563-4 [CrossRef]
Studdard WE, Davis DO, Young SW. Cortical blindness after ce- rebral angiography. Case report. J Neurosurg 1981; 54:240-4. [CrossRef]
Lantos G. Cortical blindness due to osmotic disruption of the blood-brain barrier by angiographic contrast material: CT and MRI studies. Neurology 1989;39:567-71
Merchut MP, Richie B. Transient visuospatial disorder from angio- graphic contrast. Arch Neurol 2002;59:851-4. [CrossRef]
Taylor CG, Husami Y, Colquhoun IR, Byrne JV. Direct cervical ver- tebro-venous Ş stula with radiculopathy and MRI changes resolv- ing after successful endovascular embolisation: a report of two cases. Neuroradiology 2001;43:1118-22.
Shownkeen H, Bova D, Chenelle AG, Origitano TC. Vertebral arteriovenous Ş stulas. Clinical presentation, angiographical ap- pearance and endovascular treatment. A review of twenty-Ş ve cases. Ann Radiol 1985;28:425-38.
Shownkeen H, Bova D, Chenelle AG, Origitano TC. Pediatric congenital vertebral artery arteriovenous malformation. Pediatr Radiol 2003;354-6.
Stanger P, Heymann MA, Tarnoff H, Hoffman JI, Rudolph AM. Complications of cardiac catheterization of neonates, infants, and children. A three-year study. Circulation 1974;50:595-608.
Saigal G, Bhatia R, Bhatia S, Wakhloo AK. MR Ş ndings of cortical blindness following cerebral angiography: is this entity related to posterior reversible leukoencephalopathy? AJNR 2004;25:252-6.
Mentzel HJ, Blume J, Malich A, Fitzek C, Reichenbach JR, Kaiser WA. Cortical blindness after contrast-enhanced CT: complication in a patient with diabetes insipidus. AJNR 2003;24:1114-6.