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Delayed Anoxic Encephalopathy after Carbon Monoxide Poisoning: Evaluation of Therapeutic Effect by Serial Diffusion-Tensor Magnetic Resonance Imaging and Neurocognitive Test

일산화탄소중독 이후 발생한 지연무산소뇌병증: 확산텐서영상 및 신경인지기능검사를 이용한 치료 효과의 평가

  • Ryu, Ho-Sung (Department of Neurology, School of Medicine, Kyungpook National University) ;
  • Kim, Youngwook (Department of Neurology, School of Medicine, Kyungpook National University) ;
  • Jung, Boo-Kyoung (Department of Neurology, School of Medicine, Kyungpook National University) ;
  • Kim, Yong-Won (Department of Neurology, School of Medicine, Kyungpook National University)
  • 유호성 (경북대학교 의과대학 신경과학교실) ;
  • 김영욱 (경북대학교 의과대학 신경과학교실) ;
  • 정부경 (경북대학교 의과대학 신경과학교실) ;
  • 김용원 (경북대학교 의과대학 신경과학교실)
  • Received : 2018.07.11
  • Accepted : 2018.09.11
  • Published : 2018.11.30

Abstract

Delayed anoxic encephalopathy after carbon monoxide (CO) poisoning is characterized by neurological deterioration that occurs after recovery from acute CO intoxication. There has been no established therapy. We report a patient recovered from acute CO intoxication developed various neurological symptoms. After the administration of high dose prednisolone and anticholinesterase inhibitor, the therapeutic effect was remarkable and confirmed by quantitative analysis of diffusion-tensor imaging (DTI). DTI could be used to evaluate the therapeutic effect for delayed anoxic encephalopathy after CO poisoning.

Keywords

References

  1. Weaver LK. Clinical practice. Carbon monoxide poisoning. N Engl J Med 2009;360:1217-1225. https://doi.org/10.1056/NEJMcp0808891
  2. Shin HS, Kang YJ, Kim S, Lee TK. Delayed encephalopathy after carbon monoxide poisoning improved by high dose prednisolone. J Neurocrit Care 2016;9:41-44. https://doi.org/10.18700/jnc.2016.9.1.41
  3. Yanagiha K, Ishii K, Tamaoka A. Acetylcholinesterase inhibitor treatment alleviated cognitive impairment caused by delayed encephalopathy due to carbon monoxide poisoning. Medicine (Baltimore) 2017;96:e6125. https://doi.org/10.1097/MD.0000000000006125
  4. Beppu T. The role of MR imaging in assessment of brain damage from carbon monoxide poisoning: a review of the literature. AJNR Am J Neuroradiol 2014;35:625-631. https://doi.org/10.3174/ajnr.A3489
  5. Choi IS. Delayed neurologic sequelae in carbon monoxide intoxication. Arch Neurol 1983;40:433-435. https://doi.org/10.1001/archneur.1983.04050070063016
  6. Weaver LK, Valentine KJ, Hopkins RO. Carbon monoxide poisoning: risk factors for cognitive sequelae and the role of hyperbaric oxygen. Am J Respir Crit Care Med 2007;176:491-497. https://doi.org/10.1164/rccm.200701-026OC
  7. Jeon SB, Sohn CH, Seo DW, Oh BJ, Lim KS, Kang DW, et al. Acute brain lesions on magnetic resonance imaging and delayed neurological sequelae in carbon monoxide poisoning. JAMA Neurol 2018;75:436-443. https://doi.org/10.1001/jamaneurol.2017.4618
  8. Hou X, Ma L, Wu L, Zhang Y, Ge H, Li Z, et al. Diffusion tensor imaging for predicting the clinical outcome of delayed encephalopathy of acute carbon monoxide poisoning. Eur Neurol 2013;69:275-280. https://doi.org/10.1159/000346117
  9. Lo CP, Chen SY, Chou MC, Wang CY, Lee KW, Hsueh CJ, et al. Diffusion-tensor MR imaging for evaluation of the efficacy of hyperbaric oxygen therapy in patients with delayed neuropsychiatric syndrome caused by carbon monoxide inhalation. Eur J Neurol 2007;14:777-782. https://doi.org/10.1111/j.1468-1331.2007.01854.x
  10. Chang CC, Chang WN, Lui CC, Wang JJ, Chen CF, Lee YC, et al. Longitudinal study of carbon monoxide intoxication by diffusion tensor imaging with neuropsychiatric correlation. J Psychiatry Neurosci 2010;35:115-125. https://doi.org/10.1503/jpn.090057