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Cortical blindness due to osmotic disruption of the blood-brain barrier by angiographic contrast material

CT and MRI studies

Departments of Radiology and Neurology, Albert Einstein College of Medicine, Bronx, NY.

Numerous experimental studies have demonstrated disruption of the blood-brain barrier by the hyper osmolar, iodinated contrast agents in common use for intravascular injection during radiologic studies. We report 4 cases in which cortical blindness occurred after cerebral angiography. The patients underwent x-ray CT within 1 hour. CT showed abnormal contrast enhancement in the occipital regions in all 4 instances. Two patients underwent MRI; 1 of these manifested abnormal high-signal intensity in the occipital lobes on T₂-weighted images. Only 2 previous cases documenting immediate contrast enhancement within the brain substance on CT following angiography are in the literature.

Address correspondence and reprint requests to Dr. Lantos, Department of Radiology, Montefiore Hospital, 111 East 210th Street, Bronx, NY 10467.

Received July 20,1988. Accepted for publication in final form October 25,1988.

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