| Article Access Statistics | | | Viewed | 5331 | | | Printed | 134 | | | Emailed | 2 | | | PDF Downloaded | 326 | | | Comments | [Add] | | | Cited by others | 1 | | |
|
Click on image for details.
|
|
| NEUROIMAGE |
|
|
|
| Year : 2007 | Volume
: 55
| Issue : 2 | Page : 186 |
Brain magnetic resonance imaging unveils the history of carbon monoxide poisoning
Masaki Takao1, Ban Mihara2
1 Department of Legal Medicine, School of Medicine, Keio University, Shinjuku-ku, Tokyo; Department of Neurology, Mihara Memorial Hospital, Isesaki, Gunma, Japan
2 Department of Neurology, Mihara Memorial Hospital, Isesaki, Gunma, Japan
| Date of Acceptance | 25-Sep-2006 |
Correspondence Address:
Masaki Takao
Department of Legal Medicine, School of Medicine, Keio University, Shinjuku-ku, Tokyo; Department of Neurology, Mihara Memorial Hospital, Isesaki, Gunma
Japan
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0028-3886.32808
How to cite this article:
Takao M, Mihara B. Brain magnetic resonance imaging unveils the history of carbon monoxide poisoning. Neurol India 2007;55:186 |
A 64-year-old woman was referred to our hospital because of possible viral meningo-encephalitis. Two weeks prior to admission she developed a gait disturbance followed by a fever and headache. Neurological examination showed a small steppage gait, bradykinesia, and rigidity without tremor. However, deep tendon reflexes and cognitive function were normal. Cerebrospinal fluid was normal. A test using a nasopharyngeal swab indicated active infection of influenza A virus, prompting the introduction of oseltamivir that is anti-influenzaviral drug. Magnetic resonance imaging (MRI) using T2WI showed elliptical and diffuse hyperintense lesions in the bilateral globus pallidi [Figure - 1]A and cerebral white matter [Figure - 1]B, respectively. The lesions in the globus pallidi revealed irregular hyperintensity using T1WI. A detailed interview with her disclosed that she had accidentally inhaled carbon monoxide inhalation by an oil heater four weeks earlier.
| » Discussion | |  |
CO is a well-known toxic substance that has high affinity for hemoglobin. Neuropathologic alterations of CO intoxication are characterized by hemorrhagic necrosis of the globus pallidus and demyelination of the cerebral white matter.[1] Except for acute fatal cases, individuals who recover from acute exposure of CO may develop a delayed neurological syndrome for up to 5 weeks after inhalation.[2],[3] In some instances, it may be difficult to diagnose accurately this delayed neurological syndrome because clinical settings compromise the gathering of medical histories of patients. In as much as she completely recovered from the acute manifestations of the exposure, her Parkinsonism More Details was not considered in association with carbon monoxide. This case came as a fresh reminder of the worth of MRI and the presence of delayed neurologic sequela of carbon monoxide poisoning.
| » References | | |
| 1. | Prockop LD, Naidu KA. Brain CT and MRI findings after carbon monoxide toxicity. J Neuroimaging 1999;9:175-81.  [PUBMED] |
| 2. | Kim JH, Chang KH, Song IC, Kim KH, Kwon BJ, Kim HC, et al . Delayed encephalopathy of acute carbon monoxide intoxication: Diffusivity of cerebral white matter lesions. AJNR Am J Neuroradiol 2003;24:1592-7. [PUBMED] [FULLTEXT] |
| 3. | Myers RA, Snyder SK, Emhoff TA. Subacute sequelae of carbon monoxide poisoning. Ann Emerg Med 1985;14:1163-7. [PUBMED] [FULLTEXT] |
[Figure - 1]
| This article has been cited by | | 1 |
Demystifying the fog – CT and MRI confirming the diagnosis of carbon monoxide poisoning by gas geysers |
|
| Rahat Brar,Abhishek Prasad,Shaleen Rana | | Journal of Forensic Radiology and Imaging. 2014; 2(2): 60 | | [Pubmed] | [DOI] | |
|
|
|
|
