Transient cortical blindness can also be seen in the absence of contrast enhancement at computed tomography scan after coronary angiography

Transient cortical blindness after coronary angiography or angioplasty is a rare complication. Patients with aortocoronary bypass grafts such as internal mammary artery have a seperate risk factor probably because of the direct contrast injection to the vertebral artery during the catheterisation of the internal mammary artery ostium. In most cases, computed tomography scan revealed typical, symmetrical contrast enhancement in both occipital lobes Nevertheless, transient cortical blindness can be seen after coronary angiography without contrast enhancement at computed tomography scan

Chronic paroxysmal hemicrania responsive to lamotrigine

This report details a 45-year-old woman who has been suffering right-sided temporal and orbital headache attacks during last five years. The pain is characteristically associated with ipsilateral lacrimation, ptosis and rhinorrhoea. The frequency and duration of pain increased dramatically within last two years. Detailed neurological, physical and clinical examinations as well as routine blood tests revealed no abnormality. Magnetic resonance imaging of brain was normal. The patient was clinically diagnosed as chronic paroxysmal hemicrania and initially treated with indomethacin. Due to appearance of epigastric pains indomethacin treatment was replaced with lamotrigine which successfully resolved the symptoms

Toxic encephalopathy after Atropa belladonna poisoning

An altered mentality is a common medical condition in emergency medicine. Among the causes of this, toxic etiology due to a herbal medicine is not rare. This article reports a case who was brought to emergency department because of the anticholinergic syndrome. He displayed psychomotor agitation, confusion, flushed and warmed skin, urinary retention, dry mouth and dilated pupils within 3 hours of ingesting of a plant, Atropa belladonna, which has been used as a traditional folk remedy for relieving peptic ulcer disease. He was discharged with a complete recovery after only receiving supportive therapy. Physostigmine, a cholinesterase inhibitor, was not used because of the self-limiting course. Physicians should be mindful of an anticholinergic syndrome due to herbal medicine when a patient with a history of altered mental status come to emergency department