An unusual complication of cardiac catheterization

The incidence of cerebrovascular accidents (CVA) in the context of cardiac catheterization (CC) varies from 0.07% to 0.4%, according to the literature [1,2]. And it increases to 0.8% if revascularization techniques are performed. Most cases of stroke manifest within the first 24 h, though the condition may also be diagnosed in later phases. The clinical manifestations range greatly from vision disorders (diplopia, vision loss) to motor-sensory alterations. The risk profile, according to different observational studies includes both patient factors (age, sex, weight, etc.) and factors dependent upon the technique (duration of catheterization, access route, the performance of percutaneous transluminal coronary angioplasty (PTCA), etc.), and varies with the type of CVA involved [1]. We present the case of a patient subjected to CC who developed sudden onset binocular diplopia secondary to selective involvement of the fourth cranial nerve nucleus.