{
  "abstract": "Background Contrast induced encephalopathy (CIE) is an increasingly recognized but uncommon complication of endovascular procedures. Despite increased reports, there is limited evidence to guide clinical management. We sought to identify commonly used treatments for CIE and propose management strategies to aid clinical decision making.Methods A retrospective multicenter study was conducted across 10 neurovascular centers in Australia. Cases were included based on previously proposed diagnostic criteria for CIE. Clinical features, treatments, and outcomes were extracted and analyzed. Descriptive statistics were used to characterize management strategies, and associations with clinical outcomes were assessed using Fisher's exact and χ 2 tests.Results 56 patients were identified (median age 65 years; 80.4% women). Common interventions included corticosteroids (66.1%), intravenous fluids (66.1%), and antiseizure medications (prophylactic 51.8% and therapeutic 12.5%). Half required intensive care admission for neurological monitoring. Complete recovery was achieved in 87.5% of cases. Corticosteroid administration was significantly associated with symptom resolution within 72 hours (OR 4.51, 95% CI 1.19 to 17.85, P=0.022), while intravenous fluids showed a non-significant trend toward shorter symptom duration (OR 2.25, 95% CI 0.64 to 8.15, P=0.170).Conclusions CIE generally carries a favorable prognosis. Corticosteroids appeared to shorten symptom duration and may be considered in management. Based on our findings and the existing literature, we propose a treatment algorithm to guide clinicians. Prospective validation is warranted.",
  "authors": [
    {
      "affiliations": [
        "Department of Neurosurgery, Monash Health, Clayton, Victoria, Australia",
        "Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia"
      ],
      "name": "Frederick P Mariajoseph"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Monash Health, Clayton, Victoria, Australia",
        "Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia"
      ],
      "name": "Leon T Lai"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Monash Health, Clayton, Victoria, Australia",
        "Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia"
      ],
      "name": "Adrian Praeger"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Monash Health, Clayton, Victoria, Australia",
        "Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia"
      ],
      "name": "Justin Moore"
    },
    {
      "affiliations": [
        "Department of Interventional Neuroradiology, Monash Health, Clayton, Victoria, Australia",
        "Department of Radiology, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia"
      ],
      "name": "Ronil V Chandra"
    },
    {
      "affiliations": [
        "Department of Interventional Neuroradiology, Monash Health, Clayton, Victoria, Australia",
        "Department of Interventional Neuroradiology, Austin Health, Melbourne, Victoria, Australia",
        "Department of Interventional Neuroradiology, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia"
      ],
      "name": "Hamed Asadi"
    },
    {
      "affiliations": [
        "Department of Interventional Neuroradiology, Gold Coast University Hospital, Southport, Queensland, Australia"
      ],
      "name": "Peter Fawzy"
    },
    {
      "affiliations": [
        "Department of Interventional Neuroradiology, Gold Coast University Hospital, Southport, Queensland, Australia"
      ],
      "name": "Laetitia de Villiers"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Monash Health, Clayton, Victoria, Australia",
        "Department of Interventional Neuroradiology, Monash Health, Clayton, Victoria, Australia"
      ],
      "name": "Tony Goldschlager"
    },
    {
      "affiliations": [
        "Neurological Intervention & Imaging Service of Western Australia (NIISwa), Sir Charles Gairdner, Royal Perth and Fiona Stanley Hospitals, Western Australia Department of Health, Nedlands, Western Australia, Australia",
        "Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia"
      ],
      "name": "Albert Ho Yuen Chiu"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Monash Health, Clayton, Victoria, Australia"
      ],
      "name": "Boaz Kim"
    },
    {
      "affiliations": [
        "Department of Neurology, John Hunter Hospital, Newcastle, New South Wales, Australia",
        "School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia"
      ],
      "name": "Ferdinand Miteff"
    },
    {
      "affiliations": [
        "Department of Interventional Neuroradiology, Royal Hobart Hospital, Hobart, Tasmania, Australia"
      ],
      "name": "Ramon Martin Francisco Bañez"
    },
    {
      "affiliations": [
        "Department of Interventional Neuroradiology, Austin Health, Melbourne, Victoria, Australia",
        "Department of Interventional Neuroradiology, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia"
      ],
      "name": "Davor Pavlin-Premrl"
    },
    {
      "affiliations": [
        "Department of Interventional Neuroradiology, Monash Health, Clayton, Victoria, Australia",
        "Department of Radiology, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia",
        "Department of Interventional Neuroradiology, Alfred Health, Melbourne, Victoria, Australia"
      ],
      "name": "Winston Chong"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Royal Brisbane and Woman’s Hospital Health Service District, Herston, Queensland, Australia"
      ],
      "name": "Robert Fang"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Royal Brisbane and Woman’s Hospital Health Service District, Herston, Queensland, Australia"
      ],
      "name": "Kate Mahady"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Royal Brisbane and Woman’s Hospital Health Service District, Herston, Queensland, Australia"
      ],
      "name": "Sophie Dunkerton"
    },
    {
      "affiliations": [
        "Department of Interventional Neuroradiology, Royal North Shore Hospital, Sydney, New South Wales, Australia"
      ],
      "name": "Brendan Steinfort"
    },
    {
      "affiliations": [
        "Department of Interventional Neuroradiology, Alfred Health, Melbourne, Victoria, Australia"
      ],
      "name": "Bjoern Picker"
    },
    {
      "affiliations": [
        "Department of Interventional Neuroradiology, Monash Health, Clayton, Victoria, Australia",
        "Department of Radiology, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia"
      ],
      "name": "Lee-Anne Slater"
    }
  ],
  "title": "Treatment of contrast induced encephalopathy: multicenter cohort study and proposed treatment algorithm",
  "uid": "64c9d666-1f09-51a3-9120-8020040b5e8b"
}