2000 issue 2

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Volume 9, issue 2

Case report

Sequence of neurological symptoms in an early stage of acute carbon monoxide poisoning – a case report

STANISŁAW OCHUDŁO1, ANETTA BAL1, GRZEGORZ OPALA1
1. Kliniki Neurologii Wieku Podeszłego Śląskiej Akademii Medycznej w Katowicach
Postępy Psychiatrii i Neurologii, 2000, 9, 207-212
Keywords: carbon monoxide poisoning, MRI, CT, SPECT

Abstract

In the interval form of the acutecarbon monoxide (CO) poisoning a severe impairment of consciousness occurs directly after the intoxication.This is followed by a symptom-free periodof several weeks to a few months, and thenvarious neurological and/or psychiatric symptomsappear. Brain lesions after CO poisoning areusually localized bilaterally in the white matter,striatum, hippocampus, and cerebral cortex. In thereported case of acute CO poisoning a CT andMRI assessment of the extent and nature of braindamage was performed a few days after the COpoisoning and at a 6 month follow-up. A CT scanrevealed bilateral low density areas in the whitematter. PD and T2 sequences in MRI scansshowed markedly enhanced signal areas within thewhole striatum and in the cerebral cortex, mostlyin the frontallobes. At the 6 month follow-up therewas SPECT evidence of abnormalities in the regionalcerebral blood flow in subcortical nuclei.The MRI and SPECT findings highly correlatewith the clinical picture. MRI as compared toCT seems to be a more useful technique of evaluationand monitoring of brain lesions resultingfrom CO poisoning.

Address for correspondence:
Dr Stanisław Ochudło, Klinika Neurologii Wieku Podeszłego Śląskiej Akademii Medycznej,
ul. Medyków 14, 40-752 Katowice,
tel. (0-32) 2525004,fax: (0-32) 2046164, e-mail: neurowp@infomed.slam.katowice.pl