Presentation
Suspected seizure during emergence from general anaesthesia. Complained of bilateral loss of vision.
Patient Data
Non-contrast CT - no intracranial bleed or gross structural anomaly.
CT angiography
Cannula placed in an artery, resulting in intensely opacified left axillary-subclavian artery and the branches coming off the subclavian artery, including the left vertebral artery, all the way to the distal segments of the PCAs. Enhancement of the left half of the vertebrae from the level of T2 and upward, and of the spinal cord - mostly left hemicord - from the level of C4 and upward. Bilateral enhancement of the pons, midbrain, cerebellum, occipital lobes, paramedian parietal lobes, and thalami.
Case Discussion
Underwent uterine revision under general anaesthesia, following spontaneous vaginal delivery. During emergence from anaesthesia, had a seizure and complained of transient bilateral vision loss when she came to. Neurological examination was normal, but the neurologist requested a CT angiogram.
The cannula was inadvertently placed in an artery in the antecubital fossa.
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