Ebook Neuroradiology - Expect the unexpected: Part 2
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Ebook Neuroradiology - Expect the unexpected: Part 2
CtKCkfOfCarbon Monoxide Poisoning SequelaeTwo days before being admitted to our university hospital, a young lady (28) was urgently hospitalised at a Ebook Neuroradiology - Expect the unexpected: Part 2 regional hospital after she had been found unresponsive on the bathroom floor. Carbon monoxide poisoning caused by malfunctioning gas-powered water boiler was suspected. The initial CT exam was reported as normal. Upon waking from coma, she had left-sided hemiparesis. During the next several days, Ebook Neuroradiology - Expect the unexpected: Part 2her neurological status became completely normal, but ventricular extrasystolia was noticed, so a suspicion of cardiogenic loss of consciousness aroseEbook Neuroradiology - Expect the unexpected: Part 2
. A MRI exam of the brain was requested (Fig. 11.1).The imaging findings were compatible with carbon monoxide poisoning, but not very' dramatic since CtKCkfOfCarbon Monoxide Poisoning SequelaeTwo days before being admitted to our university hospital, a young lady (28) was urgently hospitalised at a Ebook Neuroradiology - Expect the unexpected: Part 2 acute carbon monoxide poisoning (in a different patient) is shown in Fig. 11.2:11.1 Carbon Monoxide PoisoningCarbon monoxide (CO) is a colourless, odourless, tasteless, non-irritant gas produced by incomplete combustion of carbon-based fuels and substances. It is produced by common household applia Ebook Neuroradiology - Expect the unexpected: Part 2nces, heating equipment and internal combustion engine motors.Carbon monoxide poisoning is the most frequent cause of accidental poisoning and can beEbook Neuroradiology - Expect the unexpected: Part 2
fatal; it is frequently unrecognised due to its non-specific clinical presentation, unless typical history of co exposure is provided. The patient is CtKCkfOfCarbon Monoxide Poisoning SequelaeTwo days before being admitted to our university hospital, a young lady (28) was urgently hospitalised at a Ebook Neuroradiology - Expect the unexpected: Part 2 ataxia, seizures, coma, myocardial infarction and death. Long-term low-level co exposure may be the cause of chronic fatigue, memory deficits, vertigo, neuropathy. diarrhoea and abdominal pain. There may be a delayed encephalopathy of carbon monoxide intoxication, characterised by a recurrence of n Ebook Neuroradiology - Expect the unexpected: Part 2eurological or psychiatric symptoms [11. The lucid interval between acute and recurrent symptoms usually lasts 2-3 weeks. The delayed encephalopathy mEbook Neuroradiology - Expect the unexpected: Part 2
ay end with full recovery but also with progressive deterioration ending in coma or death, which depends on the severity of the initial carbon monoxidCtKCkfOfCarbon Monoxide Poisoning SequelaeTwo days before being admitted to our university hospital, a young lady (28) was urgently hospitalised at a Ebook Neuroradiology - Expect the unexpected: Part 2en-carrying capacity of the blood and the off load of oxygen to tissues is greatly reduced. This causes tissue hypoxia/anoxia. There is also a direct toxic effect of the co on mitochondria, interfering with oxidative phosphorylation. These lead to anoxic-ischaemic encephalopathy.© Springer Internati Ebook Neuroradiology - Expect the unexpected: Part 2onal Publishing AG. pan of springer Nature 2018M. spero. H. Vavro. Neunưadiology - Expect the Unexpected.https://doi.org/10.1007/978-3-319-73482-8.118Ebook Neuroradiology - Expect the unexpected: Part 2
38411 Carbon Monoxide Poisoning SequelaeFig. 11.1 MR1 exam of the brain. 6 days alter the incident. Axial T2WI (a) and axial and coronal T2-FLAIR imagCtKCkfOfCarbon Monoxide Poisoning SequelaeTwo days before being admitted to our university hospital, a young lady (28) was urgently hospitalised at a Ebook Neuroradiology - Expect the unexpected: Part 2on-weighted image(d)in the same areas may be attributed to mild residual cytotoxic oedema or to T2 shine-through—the A EX’ map(e)is normal. There is mild hypointensity in the left globus pallidus shown on the sagittal T1WI (f)11.1 Carbon Monoxide Poisoning85Fig. 11.1 (continued)Fig. 11.2 CT and MRI Ebook Neuroradiology - Expect the unexpected: Part 2findings in acute carbon monoxide poisoning (images courtesy of Prof. z. Ruinboldt). Non-enhanccd CT image (a) shows a hypodense area in the globus paEbook Neuroradiology - Expect the unexpected: Part 2
llidus bilaterally, compatible with hyperin-tense areas on MRI T2W1 image (b). There is also high DWI signal within the lesions (c). indicating low diCtKCkfOfCarbon Monoxide Poisoning SequelaeTwo days before being admitted to our university hospital, a young lady (28) was urgently hospitalised at a Ebook Neuroradiology - Expect the unexpected: Part 2 non-smokers and up to 10% in smokers. A note is made that the standard two-wavelength pulse oximetry cannot differentiate between carboxyhaemoglobin and oxyhaemoglobin [2].The treatment of co poisoning consists of administering 100% oxygen, preferably in a hyperbaric setting.Standard imaging findin Ebook Neuroradiology - Expect the unexpected: Part 2gs in acute co poisoning include symmetric CT hypodensity in globus pallidus. which is seen as low T1 and high T2 and DWI signal on MRI. There may beEbook Neuroradiology - Expect the unexpected: Part 2
a Tl hyperintensity and a rim of low T2 signal. reflecting haemorrhagic necrosis [3|. Patchy peripheral enhancement is possible in the acute phase. ThCtKCkfOfCarbon Monoxide Poisoning SequelaeTwo days before being admitted to our university hospital, a young lady (28) was urgently hospitalised at a Ebook Neuroradiology - Expect the unexpected: Part 2 [2|. In patients who develop a delayed leukoencephalopathy. there are confluent T2 hyperintense areas in the periventricular white matter with mild temporary decrease of diffusivity: the extent and degree of low ADC values are correlated with the clinical course and severity of CO intoxication ị 11 Ebook Neuroradiology - Expect the unexpected: Part 2.Differential diagnoses include other toxic encephalopathies such as cyanide neurotoxicity which may be indistinguishable from carbon monoxide poisoniEbook Neuroradiology - Expect the unexpected: Part 2
ng. Methanol poisoning typically affects the putamina. sparring the globi pal-lidi. Ethylene glycol (antifreeze) poisoning involves globi pallidi. othCtKCkfOfCarbon Monoxide Poisoning SequelaeTwo days before being admitted to our university hospital, a young lady (28) was urgently hospitalised at a Ebook Neuroradiology - Expect the unexpected: Part 2alami and brainstem. Pantothenate kinase-associated neuro-degeneration (PKAN) presents as symmetric T2 hyperintensity within iron-laden hypointense globi pallidi (“eye of the tiger").References1Ji-hoon K Ct al (2003) Delayed encephalopathy of acute carbon monoxide intoxication: diffusivity of cerebr Ebook Neuroradiology - Expect the unexpected: Part 2al white matter lesions. Am J Neuroradiol 24(8): 1592-15972Ryan AS et al (2012) Carbon monoxide poisoning: novel magnetic resonance imaging pattern inEbook Neuroradiology - Expect the unexpected: Part 2
the acute setting. Int J Emerg Med 5:303Rumboldt z Ct al (2010) Brain imaging with MRI and CT: an image pattern approach. Cambridge University Press.CtKCkfOfCarbon Monoxide Poisoning SequelaeTwo days before being admitted to our university hospital, a young lady (28) was urgently hospitalised at a CtKCkfOfCarbon Monoxide Poisoning SequelaeTwo days before being admitted to our university hospital, a young lady (28) was urgently hospitalised at aGọi ngay
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