Skip to main content
  • Home
  • Articles
    • Archive from 2022 July
    • Archive 1960 to 2022 June
    • Accepted Articles
    • Published Ahead-of-Print
    • Supplement
  • About
  • For Authors
  • Podcasts

Clinics in diagnostic imaging (154)

< Back to Listing

Share this Article

Singapore Med J 2014; 55(8): 405-410; http://dx.doi.org/10.11622/smedj.2014097
Clinics in diagnostic imaging (154)

  • Abstract
  • PDF
  • References

Lim PJ, Shikhare SN, Peh WC
Correspondence: Dr Lim Puay Joo, puayjoo@hotmail.com

ABSTRACT
A 59-year-old man with a history of major depression was found by his wife to be unconscious and foaming at the mouth. On arrival at the emergency department, the patient was noted to be unresponsive. Computed tomography of the brain showed symmetrical ill-defined areas of hypoattenuation involving the medial aspects of both lentiform nuclei, while magnetic resonance images of the brain showed symmetrical increased signal in the bilateral globi pallidi on diffusion weighted, T2-weighted and fluid attenuated inversion recovery sequences. These findings were those of acute carbon monoxide poisoning. Despite aggressive treatment, the patient’s condition continued to deteriorate and he eventually passed away. The various imaging findings of carbon monoxide poisoning in the brain and the differential diagnoses are discussed.

Keywords: basal ganglia lesions, carbon monoxide poisoning, globus pallidus necrosis, intracerebral lesions
Singapore Med J 2014; 55(8): 405-410; http://dx.doi.org/10.11622/smedj.2014097

http://smj.org.sg/sites/default/files/5508/5508me1.pdf

REFERENCES

1. Omaye ST. Metabolic modulation of carbon monoxide toxicity. Toxicology 2002; 180:139-50.
http://dx.doi.org/10.1016/S0300-483X(02)00387-6
 
2. Thom SR, Bhopale VM, Fisher D. Hyperbaric oxygen reduces delayed immune-mediated neuropathology in experimental carbon monoxide toxicity. Toxicol Appl Pharmacol 2006; 213:152-9.
http://dx.doi.org/10.1016/j.taap.2005.10.006
 
3. Gorman D, Drewry A, Huang YL, Sames C. The clinical toxicology of carbon monoxide. Toxicology 2003; 187:25-38.
http://dx.doi.org/10.1016/S0300-483X(03)00005-2
 
4. Touger M, Gallagher EJ, Tyrell J. Relationship between venous and arterial carboxyhemoglobin levels in patients with suspected carbon monoxide poisoning. Ann Emerg Med 1995; 25:481-3.
http://dx.doi.org/10.1016/S0196-0644(95)70262-8
 
5. Raub JA, Mathieu-Nolf M, Hampson NB, Thom SR. Carbon monoxide poisoning--a public health perspective. Toxicology 2000; 145:1-14.
http://dx.doi.org/10.1016/S0300-483X(99)00217-6
 
6. Hampson NB, Hauff NM. Carboxyhemoglobin levels in carbon monoxide poisoning: do they correlate with the clinical picture? Am J Emerg Med 2008; 26:665-9.
http://dx.doi.org/10.1016/j.ajem.2007.10.005
 
7. Hegde AN, Mohan S, Lath N, Lim CC. Differential diagnosis for bilateral abnormalities of the basal ganglia and thalamus. Radiographics 2011; 31:5?30.
http://dx.doi.org/10.1148/rg.311105041
 
8. Lo CP, Chen SY, Lee KW, et al. Brain injury after acute carbon monoxide poisoning: early and late complications. AJR Am J Roentgenol 2007; 189:W205-11.
http://dx.doi.org/10.2214/AJR.07.2425
 
9. O'Donnell P, Buxton PJ, Pitkin A, Jarvis LJ. The magnetic resonance imaging appearances of the brain in acute carbon monoxide poisoning. Clin Radiol 2000; 55:273-80.
http://dx.doi.org/10.1053/crad.1999.0369
 
10. Chang KH, Han MH, Kim HS, Wie BA, Han MC. Delayed encephalopathy after carbon monoxide intoxication: MR imaging features and distribution of cerebral white matter lesions. Radiology 1992; 184:117-22.
http://dx.doi.org/10.1148/radiology.184.1.1609067
 
11. Murata T, Kimura H, Kado H, et al. Neuronal damage in the interval form of CO poisoning determined by serial diffusion weighted magnetic resonance imaging plus 1H-magnetic resonance spectroscopy. J Neurol Neurosurg Psychiatry 2001; 71:250-3.
http://dx.doi.org/10.1136/jnnp.71.2.250
 
12. Kim HJ, Chang KH, Song IC, et al. Delayed encephalopathy of acute carbon monoxide intoxication: diffusivity of cerebral white matter lesions. AJNR Am J Neuroradiol 2003; 24:1592-7.
PMid:13679276
 
13. Buckley NA, Isbister GK, Stokes B, Juurlink DN. Hyperbaric oxygen for carbon monoxide poisoning: a systematic review and critical analysis of the evidence. Toxicol Rev 2005; 24:75-92.
http://dx.doi.org/10.2165/00139709-200524020-00002
 
14. Buckley NA, Juurlink DN, Isbister G, Bennett MH, Lavonas EJ. Hyperbaric oxygen for carbon monoxide poisoning. Cochrane Database Syst Rev 2011; CD002041.
PMid:21491385
×

Around the Site

Home

About SMJ

For Reviewers

Sign Up for Alerts

Issues

Current Issue

All Issues

Online First

Supplement

CME

For Authors

Instructions for Authors

Submit Manuscript


Follow us on:
        

More Links

Contact Us

Copyright

Advertise

SMJ Forms

Privacy Policy

SMA Home

Copyright 2021. Singapore Medical Association. All Rights Reserved.