Subarachnoid gadolinium following angiography-induced cortical blindness

A 49-year-old man developed transient (48 hours) cortical blindness following diagnostic cerebral angiography (normal) that had been performed to investigate a cerebellar haemorrhage from 6 months before. His blood pressure was normal during the diagnostic angiography. Gadolinium-enhanced MR scan of brain 2 hours after angiography showed restricted diffusion in the occipital cortex, predominantly left sided, with normal fluid attenuation inversion recovery (FLAIR) sequences (figure 1). Seven hours later, diffusion-weighted imaging was unchanged but FLAIR showed bilateral subarachnoid occipital hyperintensities which were not visible on other sequences, including T2*-weighted imaging (figure 1). Six days later, repeat imaging was completely normal (figure 1). Figure 1 Initial gadolinium-injected MR scan of brain showing restricted diffusion predominantly in the left occipital cortex (A, diffusion-weighted imaging; B, apparent diffusion coefficient), with normal fluid attenuation inversion recovery (FLAIR) imaging (C). MR scan of …