Abstract：
Understanding the risks of contrast-induced encephalopathy (CIE), a serious complication of contrast agents, is crucial in endovascular treatment. We present the case of a 73-year-old woman who developed CIE in the medulla and cervical cord during coil embolization for unruptured left basilar-superior cerebellar artery and basilar artery tip aneurysms. The CIE was identified via neuromonitoring. In this case, spinal cord ischemia might have occurred due to reduced perfusion pressure after inserting the distal access catheter (DAC) in the vertebral artery. Multiple injections of contrast medium via the DAC during coil embolization likely contributed to an unusual form of CIE. Extreme caution is warranted during endovascular treatments involving the posterior circulation, due to the relatively high incidence of contrast-mediated encephalopathy, which can lead to severe consequences such as perforator infarction. Neuromonitoring is very useful for the early detection of neurological changes, particularly because intraoperative angiography may not reveal all irregularities.
摘要：
了解造影剂脑病（CIE）的风险，造影剂的严重并发症，在血管内治疗中至关重要。我们介绍了一名73岁的妇女的病例，该妇女在未破裂的左基底小脑上动脉和基底动脉尖动脉瘤的线圈栓塞期间在延髓和颈髓中发展了CIE。E是通过神经监测确定的。在这种情况下,脊髓缺血可能是由于将远端入路导管(DAC)插入椎动脉后灌注压降低所致.在线圈栓塞期间通过DAC多次注射造影剂可能导致了CIE的异常形式。在涉及后循环的血管内治疗期间需要格外小心，由于对比剂介导的脑病的发生率相对较高，这可能会导致严重的后果，如穿孔梗塞。神经监测对于早期发现神经变化非常有用，特别是因为术中血管造影可能无法揭示所有不规则性。
