doi: 10.5505/abantmedj.2015.28291 Abant Medical Journal Olgu Sunumu / Case Report Volume Cilt 4 Issue Sayı 1 Year Yıl 2015 İletişim Bilgisi / Correspondence 1 Uzm. Dr. İhsan Alur, Pamukkale Üniversitesi Tıp Fakültesi, Kalp Ve Damar Cerrahisi Anabilim Dalı, Denizli E-mail: alur_i@hotmail.com Geliş tarihi / Received: 10.03.2014 Kabul tarihi / Accepted: 07.04.2014 Çıkar Çatışması / Conflict of Interest: Yok / None A Rare Complication After Conventional Coronary Angiography: Left Homonymous Hemianopia Konvansiyonel Koroner Anjiografi Sonrası Nadir Bir Komplikasyon: Sol homonim Hemianopsi İhsan Alur 1 , Veli Çıtışlı 2 , Gökhan Pekel 3 , Tevfik Güneş 1 , Gökhan Yiğit Tanrısever 1 , Gökhan Önem 1 1 Pamukkale Üniversitesi Tıp Fakültesi, Kalp Ve Damar Cerrahisi Anabilim Dalı, Denizli 2 Pamukkale Üniversitesi Tıp Fakültesi, Beyin Cerrahisi Anabilim Dalı, Denizli 3 Pamukkale Üniversitesi Tıp Fakültesi, Göz Hastalıkları Anabilim Dalı, Denizli Özet Abstract Koroner arter hastalığının tanısında konvansiyonel koroner anjiografi altın standart olarak kabul edilmektedir. Ancak tanısal veya girişimsel amaçlı koroner anjiografi sırasında serebrovasküler olay gerçekleşebilir. Bu durum hastaya ait risklere veya işlemin invaziv olmasına bağlıdır. Hastada yaygın aterosklerotik damar hastalığı, kalsifik veya mural trombüs içeren aort anevrizması ya da inflamatuvar aortit gibi patolojilerden biri varsa ateroembolizm için risk oluşturur. Bu yazıda tanısal amaçlı koroner anjiografiden sonra sol homonim hemianopsi bulgusuyla beyin BT’de serebral enfarktüs tanısı konan olgu sunuldu. In coronary artery disease, coronary angiography is considered as a golden standard diagnostic tool. But, during diagnostic or interventional procedure of coronary angiography, cerebrovascular accidents may occur due to the procedure itself or risk factors related to the patient, mainly when the patient has diffuse atherosclerosis, aortic aneurysm with calcification, mural thrombosis or inflammatory aortitis. In this case report, we will present a case of left homonymous hemianopsia (HH) occurred after diagnostic coronary angiography and identified by CT-Scan which showed a cerebral infarction. Anahtar Kelimeler: Görme, beyin, enfarkt, koroner, anjiografi. Keywords: Vision, brain, infarction, coronary, angiography. Introduction The incidence of clinically overt stroke following coronary angiography (CAG) is less than 0.3 %. However, the incidence of asymptomatic cerebral infarct might be significantly higher (1). It has been shown that microemboli may occur in cerebral arteries during CAG (2, 3). Cerebrovascular embolism (CVE) following CAG or left cardiac catheterization is related to many factors. A thrombus might be formed on or around the catheter and might be carried by the guide wire to various cerebral arteries. Additionally, an air embolism or microparticles (debris) that may have separated from atheromatous plaques in the aorta or its branches may cause CVE (4). Occipital infarcts, optic tract damages and lesions of the optic chiasm are the most common reasons of visual field loss following stroke (5). Hemianopsia constitutes 70% of all visual field loss that occur in the cerebral artery infarcts (6). Homonymous visual field defects occur in approximately 8% patients who have experienced a stroke (7). It was shown that the risk of cerebral embolism is higher when CAG is done via the radial artery when compared to the femoral artery. Additionally, it was reported that microemboli risk is higher in CAG via the right radial artery (2). In our case, we performed a CAG via the right brachial artery, because the patient had peripheral artery disease. In a previous study, it was found that age, hypertension, diabetes and impairment on renal functions were related to the homonymous visual field defects (7). In this report, we present a case that had left homonymous hemianopsia (HH) and cerebral infarct on cranial CT following coronary angiography. Figure 1. The brain MRI section of the patient.