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Gadoxetate Disodium-Enhanced Imaging of Gradenigo Syndrome in End-Stage Renal Disease
- Source :
- Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society. 41(3)
- Publication Year :
- 2021
-
Abstract
- A 65-year-old man with end-stage renal disease on peritoneal dialysis was admitted for new onset binocular double vision, failure to thrive, and debilitating right-sided headaches. Medical history was significant for tympanomastoidectomy for polymicrobial mastoiditis and treatment with IV antibiotics. MRI brain without contrast was read by radiology initially as showing expected postsurgical changes; however, given patient's history of mastoiditis infection, there was a high clinical suspicion for Gradenigo syndrome. MRI brain was repeated with gadoxetate contrast to minimize the risk of nephrogenic systemic fibrosis (NSF) in a patient with severe renal disease and this revealed an intracranial empyema involving both the trigeminal and abducens nerves confirming the diagnosis of Gradenigo syndrome. This case presented a diagnostic challenge because of suboptimal visualization on initial nonenhanced MRI. Gadoxetate was chosen because of its unique properties including high hepatobiliary excretion making it a safer form of gadolinium-based contrast agent that may not have the potential to precipitate NSF.
- Subjects :
- Gadolinium DTPA
Male
Mastoiditis
medicine.medical_specialty
medicine.medical_treatment
Gradenigo Syndrome
Contrast Media
Peritoneal dialysis
End stage renal disease
Gadoxetate Disodium
medicine
Humans
Medical history
Aged
business.industry
Brain
medicine.disease
Magnetic Resonance Imaging
Empyema
Ophthalmology
Nephrogenic systemic fibrosis
Kidney Failure, Chronic
Petrositis
Neurology (clinical)
Radiology
business
Subjects
Details
- ISSN :
- 15365166
- Volume :
- 41
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society
- Accession number :
- edsair.doi.dedup.....d5320470b9e05d55b1aff74f5332d835