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| NEUROIMAGES |
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| Year : 2017 | Volume
: 65
| Issue : 3 | Page : 672-673 |
Carbon monoxide toxicity: A reversible damage to brain
Ayush Dubey, Dinesh Chouksey
Department of Neurology, SAIMS Medical College, SAIMS, Indore, Madhya Pradesh, India
| Date of Web Publication | 9-May-2017 |
Correspondence Address:
Ayush Dubey
E-29, 45 Bungalows, T T Nagar, Bhopal, Madhya Pradesh
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/neuroindia.NI_990_16
How to cite this article:
Dubey A, Chouksey D. Carbon monoxide toxicity: A reversible damage to brain. Neurol India 2017;65:672-3 |
A 55-year old female patient with previously normal neurological status was found unconscious in her house one winter morning. On examination, she was drowsy, arousable with decreased attention span and no focal neurological deficits. Her arterial blood gas showed hypoxemia. She had gradual improvement in her sensorium and hypoxemia with intranasal oxygen. She provided a history of cooking food on a household stove using wood and coal in a tightly closed room, and she slept without putting off the stove. Her magnetic resonance imaging (MRI) of the brain showed bilateral symmetrical globus pallidus hyperintensities on T2 and fluid-attenuated inversion recovery (FLAIR) sequences [Figure 1]. A diagnosis of carbon monoxide toxicity was made.[1] These hyperintensities disappeared on a follow-up MRI at 2 months[Figure 2]. In a closed room, fumes of burning wood and coal produces carbon monoxide which combines with hemoglobin reversibly and replaces oxygen, leading to hypoxemia. This special situation which leads to this presentation of isolated globus pallidus involvement is not much reported.[2] The presentation of these patients can be variable ranging from slight headache and dizziness to coma. Our patient recovered in 24–48 hours with no recurrence in follow-up.[3] | Figure 1: Axial T2 FLAIR and diffusion weighted images showing bilateral symmetrical globus pallidi hyperintensities
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 | Figure 2: Follow-up scan after 2 months showing resolution of the hyperintensities
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Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| » References | |  |
| 1. | Subhaschandra S, Jatishwor W, Suraj T. Isolated symmetrical bilateral basal ganglia T2 hyperintensity in carbon monoxide poisoning. Ann Indian Acad Neurol 2008;11:251-3.  [ PUBMED] [Full text] |
| 2. | Sharma P, Eesa M, Scott J. Toxic and acquired metabolic encephalopathies: MRI appearance. Am J Radiol2009;193:879-86. |
| 3. | Kinoshita T, Sugihara S, Matsusue E, Fujii S, Ametani M, Ogawa T. Pallidoreticular damage in acute carbon monoxide poisoning: Diffusion-weighted MR imaging findings. Am J Neuroradiol 2005;26:1845-8. [ PUBMED] |
[Figure 1], [Figure 2]
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