Nonionic contrast neurotoxicity after coronary angiography mimicking subarachnoid hemorrhage.

Introduction The incidence of neurotoxic events due to intravascular application of iodinated x-ray contrast media (CM) has decreased markedly since the introduction of nonionic CM [1]. Severe neurotoxic complications are accompanied by disruption of the blood-brain barrier and CM extravasation [1–6]. Coronary angiography involving only nonionic CM has been reported to cause transient cortical blindness, confusion and amnesia, but no focal deficits [3, 4], whereas coronary angiography involving ionic CM was followed by more severe complications including seizures, motor and speech deficits [5, 6]. Here we report on a patient who developed transient hemiparesis, aphasia and confusion due to neurotoxicity of nonionic CM after coronary angiography, and whose CT findings mimicked subarachnoid hemorrhage (SAH).