Recurrent Transient Cortical Blindness After Bilateral Carotid Artery Stenting

Division

West Florida

Hospital

Blake Medical Center

Document Type

Case Report

Publication Date

3-18-2026

Keywords

carotid artery stenting, contrast-induced encephalopathy, recurrence, stroke mimic, transient cortical blindness

Disciplines

Cardiovascular Diseases | Internal Medicine | Medicine and Health Sciences | Nervous System Diseases | Surgical Procedures, Operative

Abstract

BACKGROUND: Transient cortical blindness is a rare manifestation of contrast-induced encephalopathy and an important stroke mimic after angiographic procedures.

CASE SUMMARY: An 84-year-old man developed acute bilateral cortical blindness with encephalopathy immediately after right internal carotid artery stenting. Neuroimaging was normal, and symptoms resolved completely within 20 hours. Four years later, he underwent left internal carotid artery stenting with minimized contrast volume and prophylactic corticosteroids and antihistamines, yet experienced an identical episode with full recovery. Both events were temporally related to contrast exposure and lacked imaging evidence of infarction or hyperperfusion injury.

DISCUSSION: This case highlights persistent susceptibility to contrast-induced neurotoxicity, distinguishes it from ischemic stroke and hyperperfusion syndromes, and expands the literature by demonstrating recurrence after sequential bilateral carotid artery stenting.

TAKE-HOME MESSAGES: Recurrent transient cortical blindness can occur years apart after carotid artery stenting and should be recognized promptly to avoid unnecessary interventions.

Publisher or Conference

JACC Case Reports

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