A 55-year-old woman who had undergone cardiac catheterization in 2004 and Da Vinci robotic surgery for mitral valve repair in 2005 presented with headaches and a brain magnetic resonance image showing multiple microhemorrhages. Magnetic resonance imaging of the brain and cervical spine from 2009 (Figure 1 and Figure 2) showed innumerable susceptibility artifacts not seen in 2003. Head computed tomographic results were normal (Figure 1). We presumed that our patient had metallic microemboli following either the cardiac catheterization or robotic surgery.1- 3 Our patient also had cervical cord involvement, which has not been previously reported to our knowledge. Neurologists should be aware of these iatrogenic susceptibility artifacts to avoid misdiagnosing them as microhemorrhages and potentially stopping necessary anticoagulation treatment.
Roshal D, Snapp M, Friedman DP, Zangaladze A. Iatrogenic Brain and Cervical Cord Magnetic Resonance Imaging Susceptibility Artifacts From Metallic Microemboli. Arch Neurol. 2011;68(1):132-133. doi:10.1001/archneurol.2010.336