Cardiac-Neurovascular Adverse Effects Responsible to Contrast Transcranial Doppler: A Case Report

Introduction and Case Presentation: A 44-year-old female patient suffered migraines and underwent contrast-enhanced transcranial Doppler (c-TCD). During the rapid injection of contrast agent, she suffered chest tightness, palpitation, decreased consciousness, perimouth numbness, and headache, respectively. Meanwhile, “curtain” pattern of air embolic signals lasted up to 115 seconds in her decreased right middle cerebral artery accompanied with arrhythmia. The microair embolic signals lasted as long as 340 seconds. The patient's symptoms were relieved in 30 minutes. The aforementioned symptoms and signs occurred, lasted, then disappeared coinciding in time with changes of microbubbles. The woman was later found to have ventricular septal defect. Discussion: The adverse effects to cardiac-neurovascular system of c-TCD are reported for the first time, which arouse attention to safety of the procedure.