Table 1.

Cases of CIE reported within the last 10 years

Agent	Symptom	Duration	Treatment
tPA, no contrast [12]	Transient cortical blindness; MRI diffuse hyperintensities in the subarachnoid space in a fluid-attenuated inversion recovery sequence	3 days
110 mL iopromide [4]	Respiratory distress, erythema on trunk, drowsiness, confusion, disorientation, complete aphasia, muscle weakness	Leg strength returned in 6 h, speech in 12 hours	IV fluids
120 mL iopromide [4]	Drowsiness, confusion, disorientation, muscle weakness	Within hours	IV hydrocortisone 3X daily with IV fluids
150 mL ioversol [1]	Consciousness disturbance, global aphasia, cortical blindness, right-sided weakness	2 days	IV fluids with normal saline
110 mL iopramidol [13]	Headache, dizziness, nausea; CT scan 2 days after symptoms started showed diffuse cerebral edema with loss of gray-white differentiation, effacement of cerebral sulci, decrease cerebrospinal fluid	56 days– died from cerebral edema	Ramosetron and dexamethasone
120 mL iohexol for angiography; 220 mL iopramide for procedure [3]	Complete right hemiparesis, sensory loss, right-sided neglect	20 days; motor power returned in one year	Dexamethasone and mannitol
Iodixanol [2]	Left hemiparesis, sensory loss, left-sided neglect	6 days	IV fluids, dexamethasone, mannitol, anticonvulsant
Iohexol [14]	Headache, transient cortical blindness, seizure, focal neuro deficits; CT showed slight enhancement of venous sinuses and cerebral arteries	2 days	IV fluids
Iopamidol [15]	Severe headache, agitation, altered mentation, skin hypersensitivity; CT showed an increased density of falx and tentorium; MRI after 48 h showed small-vessel ischemia and age-related changes	Mental status and agitation resolved in 48 h; headache resolved after several days	IV fluids, acetaminophen, NSAIDs
Iohexol [16]	Confusion, cortical blindness, seizure	1 day	IV fluids and sedation medication
Analgesia pump with gadolinium via fluoroscopy [17]	Encephalopathy, expressive aphasia, confusion; noncontrast CT showed diffuse hypoattenuation of basal cisterns determined to be residual gadolinium contrast	6 days	IV fluids
120 mL iohexol [18]	Confusion	9 days	Supportive care
Iopamidol (4 patients), and iodixanol (1 patient), mean dose 220 mL [19]	Hemiparesis, convulsions, blindness, consciousness disturbance, hemiparesis, agnosia, aphasia	Improvement after hemodialysis; recovery after 1 week	Hemodialysis to remove contrast and steroids

The most common presenting symptoms of CIE include confusion, aphasia, cortical or transient blindness, hemiparesis, disorientation, headache, drowsiness, and seizures. The less common symptoms include muscle weakness, dizziness, nausea, vomiting, sensory loss, neglect, skin abnormalities, and loss of consciousness. Different symptoms appear in bold on the table. Of the cases reported within the last 10 years, most incidences of CIE resolved within 2–3 days.

CIE, contrast-induced encephalopathy; CT, computed tomography; tPA, tissue plasminogen activator.