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

BACKGROUND Contrast-induced encephalopathy(CIE)is a rare transient,reversible abnormality in the structure or function of the nervous system caused by the intravascular use of contrast agents.CIE can present with a range of neurological manifestations,including focal neurological deficits(hemiplegia,hemianopia,cortical blindness,aphasia,and parkinsonism)and systemic symptoms(confusion,seizures,and coma).However,if not accurately diagnosed and treated in a timely manner,CIE can cause irreversible damage to patients,especially critically ill patients.CASE SUMMARY A male in his 50 s,2 h after digital subtraction angiography,had a progressive disorder of consciousness,mixed aphasia,bilateral pupillary sluggish light reflex,and right limb weakness.Seven hours after the procedure,he developed unconsciousness,high fever(39.5°C),seizures,hemiplegia,neck stiffness(+),and right Babinski signs(+).computed tomography(CT)findings 2 h postprocedure were very confusing and led us to misdiagnose the patient with subarachnoid hemorrhage.Brain CT was performed again 7 h after the procedure.Compared with the CT 2 h after the procedure,the CT 7 h after the procedure showed that the manifestations of subarachnoid hemorrhage in the left cerebral hemisphere had disappeared and were replaced by brain tissue swelling,and the cerebral sulci had disappeared.Combined with the clinical manifestations of the patient and after the exclusion of subarachnoid hemorrhage and cerebrovascular embolism,we diagnosed the patient with CIE,and intravenous fluids were given for adequate hydration,as well as mannitol,albumin dehydration,furosemide and the glucocorticoid methylprednisolone.After 17 d of active treatment,the patient was discharged with no sequelae.CONCLUSION CIE should be taken seriously,but it is easily misdiagnosed,and once CIE is diagnosed,rapid,accurate diagnosis and treatment are critical steps.Whether a follow-up examination using a contrast agent can be performed should be closely evaluated,and the patient should be fully informed of the associated risks.

Overweight and Obesity-Induced Oxidative Stress in Children

Objective To investigate whether overweight and obesity might cause oxidative stress and potential oxidative damage in overweight and obese children, and to explore its possible mechanism. Methods Eighty-five overweight and obese children （OOC）, and eighty-five age-matched healthy children （HC） were recruited in this case-control study. The present study analyzed spectrophotometrically vitamin C （VC）, vitamin E （VE）, and β-carotene （β-CAR） in plasma, as well as the activities of superoxide dismutase （SOD）, catalase （CAT）, and the level of malondialdehyde （MDA） in erythrocytes. Results Compared with those of VC, VE, β-CAR, SOD, CAT and MDA in the HC group, the average values of VC, VE, β-CAR, SOD, and CAT in the OOC group were significantly decreased （P〈0.001）, while the average value of MDA in the OOC group was significantly increased （P〈0.001）. The regression analysis demonstrated that VC, VE, β-CAR, SOD, and CAT were negatively correlated （P〈0.05-0.01）, and MDA was positively correlated with BMI （P〈0.05）. Fitting to the model of multiple stepwise regression of BMI on VC, VE, β-CAR, SOD, CAT, and MDA in 85 OOC was Y = 27.0041 ＋ 0,2541MDA - 2.1448β-CAR -- 0.0090CAr, where F = 43.8088, P〈0.001, r = 0.7866, r^2= 0.6187, adjusted r^2= 0.6046. The findings from the reliability analysis for VC, VE, β-CAR, SOD, CAT, and MDA used to reflect increased oxidative stress and potential oxidative damage in the OOC showed that the reliability coefficients （alpha, 6 items） = 0.7231, P〈0.0001, and that the standardized item alpha = 0.9207, P〈0.0001, Conclusion The present study suggests that there exists an increased oxidative stress in overweight and obese children.