[Extravasation of contrast media in brain parenchyma and cerebrospinal fluid space after CT or DSA of thorax or abdomen]. / Kontrastmittelextravasation in Hirnparenchym und Liquorraum nach CT oder DSA von Thorax und Abdomen.

PURPOSE: Analysis of clinical and CT findings in patients with signs of disruption of the blood-brain or blood-CSF barrier after i.v. or i.a. administration of non-ionic contrast media. METHODS: 1. Retrospective analysis of 8 patients with clinical and CT findings of disruption of the blood-brain or blood-CSF barrier after i.v. or i.a. administration of non-ionic contrast media (200-450 ml). 2. Prospective analysis of 30 intensive care patients with sepsis and suspected abscess, who underwent CT of the chest and abdomen with 240 ml of a non-ionic contrast medium followed by cranial CT to rule out septic lesions. RESULTS: The retrospective analysis proved that disruption of the blood-brain barrier may occur in elderly patients with risk factors after injection of higher amounts of contrast media. In the prospective study, equivalent CT phenomena were observed in 3 of 30 patients with sepsis. CONCLUSIONS: Hypoxemic and toxics damage to the blood-brain barrier as well as higher amounts of contrast media may result in extravasation of contrast medium into the CSF space, which can be demonstrated by CT. For differential diagnosis, the clinical symptoms and CT patterns of a disruption of the blood-brain or blood-CSF barrier should be known.