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Transient cortical blindness following cerebral angiography was previously assumed to result from embolism or other factors impairing cortical perfusion during angiography. Contrast medium-induced disruption of the blood-brain barrier and a direct neurotoxic effect by contrast media have been proposed as a potential mechanism of neurotoxicity. Support of this concept has been provided by reports that demonstrate blood-brain barrier damage with postangiography computerized tomography in patients experiencing various acute neurologic sequelae of cerebral angiography including one case of transient cortical blindness. We report a case of transient cortical blindness following cerebral angiography in which computerized tomography documents blood-brain barrier disruption limited to the occipital lobes.
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