Atormac
Neurology India
menu-bar5 Open access journal indexed with Index Medicus
  Users online: 2346  
 Home | Login 
About Editorial board Articlesmenu-bullet NSI Publicationsmenu-bullet Search Instructions Online Submission Subscribe Videos Etcetera Contact
  Navigate Here 
 Search
 
   Next article
   Previous article 
   Table of Contents
  
 Resource Links
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Article in PDF (85 KB)
    Citation Manager
    Access Statistics
    Reader Comments
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this Article
   Discussion
   References
   Article Figures

 Article Access Statistics
    Viewed3973    
    Printed70    
    Emailed2    
    PDF Downloaded320    
    Comments [Add]    
    Cited by others 1    

Recommend this journal

 


 
NEUROIMAGE
Year : 2007  |  Volume : 55  |  Issue : 2  |  Page : 186

Brain magnetic resonance imaging unveils the history of carbon monoxide poisoning


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 Acceptance25-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
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.32808

Rights and Permissions



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

How to cite this URL:
Takao M, Mihara B. Brain magnetic resonance imaging unveils the history of carbon monoxide poisoning. Neurol India [serial online] 2007 [cited 2019 Sep 19];55:186. Available from: http://www.neurologyindia.com/text.asp?2007/55/2/186/32808


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 Top


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 Top

1.Prockop LD, Naidu KA. Brain CT and MRI findings after carbon monoxide toxicity. J Neuroimaging 1999;9:175-81.  Back to cited text no. 1  [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.  Back to cited text no. 2  [PUBMED]  [FULLTEXT]
3.Myers RA, Snyder SK, Emhoff TA. Subacute sequelae of carbon monoxide poisoning. Ann Emerg Med 1985;14:1163-7.  Back to cited text no. 3  [PUBMED]  [FULLTEXT]


    Figures

  [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]



 

Top
Print this article  Email this article
Previous article Next article
Online since 20th March '04
Published by Wolters Kluwer - Medknow