Unilateral contrast-induced encephalopathy with contrast medium exudation: A case report

Table 1 Patient’s nervous system physical examination during hospitalization

	Preoperative	2 h after DSA	7 h	3 d	6 d	On discharge
Vital signs	R 22 times/min; P 90 times/min; H 170 cm; T 36.2 °C; W 75 kg; BP 118/81 mmHg		High fever (39.5 °C)
Nervous system examination findings	The patient was conscious, with fluent speech and equal-sized and round pupils with a diameter of 3 mm. The presence of light reflex, flexible eye movements in all directions, bilateral nasolabial fold symmetry, and tongue protrusion to the left was noted. Other cranial nerves were normal. His limb muscle strength was grade 5 and muscle tension was acceptable, tendon reflexes (++), and bilateral pathological signs were negative. His sense of depth and lightness was normal, and motor function was normal	He suddenly had slurred speech, accompanied by right limb weakness	He developed unconsciousness, high fever (39.5 °C), seizures, hemiplegia of the right limb, neck stiffness (+), and right Babinski signs (+)	His consciousness gradually improved, he was able to open eyes voluntarily, and he could answer simple questions even though he was not fluent in speech. His pupils were equal in size and round, with a diameter of 3 mm. His light reflex was sluggish, his eyes moved flexibly in all directions, and his bilateral nasolabial folds were symmetrical. His muscle tension of the four limbs was acceptable, the left limb movement was acceptable, the right limb muscle strength was grade 3, tendon reflexes (+), and right pathological signs (+)	The patient was clearly conscious, but his speech was still not fluent. The seizures did not recur.The muscle strength of the healthy limb recovered to grade 4	The patient was conscious and in good spirits. He had fluent speech. Both pupils were of equal size and were round, 3 mm in diameter. The presence of the light reflex, flexible eye movements in all directions, bilateral nasolabial fold symmetry, and tongue protrusion to the left (same as preprocedure) was noted. The remaining cranial nerves were not (see exception). The muscle strength of the limbs was grade 5, the muscle tension was acceptable, the tendon reflex (+), and the bilateral Babinski signs were negative

DSA: Digital subtraction angiography; R: Respiratory; P: Pulse; H: Height; W: Weight; BP: Blood pressure.