Saturday, 3 August 2019

Carbon monoxide poisoning


Due to accidental acute intoxication
Has relatively high mortality
Causes neurological hypoxic damage
CO has high affinity for haemoglobin than oxygen (200 folds)
Carboxyhemoglobin reduces the ability of haemoglobin to transport oxygen

Clinical features
  • Headache, tinnitus, dizziness, nausea, progressive disorders of consciousness till death
  • Survivors will have severe extra pyramidal disorder/ dementia

Radiological features
  • Bilateral Globus pallidus necrosis,
  • Extending to lenticular nuclei, caudate, rarely thalami & hippocampus
  • Distal frontal white matter involvement also positive
  • CT- low attenuation in affected areas above
  • MRI- T1 hypo, T2 hyper, if microblading inhomogeneous
         Subcortical white matter hyperintensity in severe cases
         T1C(Gd) patchy peripheral enhancement
  • Acute phase- DWI diffusion restriction in basal ganglia
  • Temporal involvement is rare
  • Lesions gradually evolved towards cavitation & atrophy

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Carbon monoxide poisoning

Due to accidental acute intoxication Has relatively high mortality Causes neurological hypoxic damage CO has high affinity for hae...