Carbon monoxide poisoning with an atypical presentation on MRI: Case report and literature review. (October 2022)

• Record Type: Journal Article
• Authors: Saji, Alen Sam; Raza, Muhammad Hassan; Anjum, Abdul Sattar; Maqsood, Hamza; Yousaf, Javeriya; Saleem, Sheraz
• Is Part Of: Annals of medicine and surgery. Volume 82(2022)
• Publication Date: 2022-10
• Subjects: Carbon monoxide -- Poisoning -- Neurology -- MRI -- Altered mentation; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2022.104655
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Introduction: Acute carbon monoxide poisoning can present with altered mentation, loss of consciousness, and other symptoms. Accurate diagnosis is based on a detailed history, clinical examination, and laboratory evidence. MRI is also crucial in detecting hypoxic-ischemic encephalopathy due to CO poisoning and has established superiority over CT scans. We report an atypical MR imaging pattern seen in a patient post-CO exposure. Case presentation: We report a case of a 35-year-old South Asian man who presented to the emergency department with loss of consciousness for an undetermined time. GCS on arrival was 4/15. Detailed history, physical examination, and radiological investigations confirmed the diagnosis of carbon monoxide poisoning. He was treated with 100% oxygen. Conclusion: MRI should be included as a diagnostic workup for suspected CO poisoning patients to evaluate hypoxic-ischemic encephalopathy. This will not only aid in the correct diagnosis but will also help in guiding the correct management of the patients. Highlights: Acute carbon monoxide poisoning can present with altered mentation, loss of consciousness, and other symptoms. MRI is also crucial in detecting hypoxic-ischemic encephalopathy due to CO poisoning and has established superiority over CT scans. MRI should be included as a diagnostic workup for suspected CO poisoning patients to evaluate hypoxic-ischemic encephalopathy. This will not only aid in the correct diagnosis but will also help in guiding the correct management of the patients.