Carbon monoxide poisoning

  • Affinity of carbon monoxide for Hb is 250 times for than oxygen
  • Carboxyhemoglobin reduces oxygen carrying capacity of Hb
  • Headache, tinnitus, dizziness, nausea
  • Survivors have severe extrapyramidal disorder or dementia
  • Bilateral globus pallidus necrosis, sometimes involved lenticular nuclei and caudate. Thalami and hippocampi rarely involved. Sometimes distal frontal matter involved
  • MRI
    • Bilateral basal ganglia low T1, high T2
    • Microbleeds may be seen
    • When severe, symmetric involvement of white matter of periventricular region, corpus callosum, internal capsule, subcortical white matter, cerebellar white matter
    • Acute phase – DWI restriction in basal ganglia
    • Eventually lesions cavitate and atrophy
Read more

Horowitz, A. L., R. Kaplan, and G. Sarpel. “Carbon monoxide toxicity: MR imaging in the brain.” Radiology 162.3 (1987): 787-788.

Chang, Kee Hyun, et al. “Delayed encephalopathy after acute carbon monoxide intoxication: MR imaging features and distribution of cerebral white matter lesions.” Radiology 184.1 (1992): 117-122.