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The Role of MR Imaging in Assessment of Brain Damage from Carbon Monoxide Poisoning: A Review of the Literature

T. Beppu
American Journal of Neuroradiology April 2014, 35 (4) 625-631; DOI: https://doi.org/10.3174/ajnr.A3489
T. Beppu
aFrom the Department of Neurosurgery, Department of Hyperbaric Medicine, Iwate Medical University, Morioka, Japan.
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    Fig 1.

    Atrophic change of the hippocampus and cerebral cortex in a 61-year-old woman after CO poisoning. When compared with initial T2-weighted imaging in the acute phase (A), imaging at 3 months after CO inhalation demonstrates enlargement of the bilateral inferior horns of the lateral ventricles and expansion of the cerebral sulci, suggesting atrophy of the hippocampus and cerebral cortex (B). Recent memory disturbance was recovered, but persistent chronic symptoms including slow movement and personality change remained at 3 months after CO inhalation.

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    Fig 2.

    Hyperintensities in the deep WM involving the centrum semiovale in a 53-year-old man with DNS after CO poisoning. A, T2-weighted imaging within 24 hours after CO inhalation reveals slight hyperintensity in the bilateral deep WM and shows a necrotic focus in the left parietal lobe. B, At 2 days after the occurrence of DNS, hyperintense areas appear widespread in the bilateral deep WM. Brain atrophy is also apparent in the bilateral frontal lobes.

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    Fig 3.

    High-sensitivity DWI in the acute phase after CO poisoning in a 64-year-old woman. A, T2-weighted imaging; B, FLAIR; and C, DWI, all taken within 24 hours after CO inhalation. D, T2-weighted imaging at 3 months after CO poisoning. T2-weighted imaging (A) and FLAIR (B) did not demonstrate clear abnormalities in the basal ganglia within 24 hours after CO poisoning, but markedly high signals were depicted in the bilateral GP on DWI (C) at the same time. Clear hyperintense areas in the bilateral GP were found on T2-weighted imaging after 3 months (D).

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    Fig 4.

    Detection of damaged regions of the CWM by use of voxel-based analysis with DTI. When FA values in all voxels on the FA map were compared voxel by voxel between 2 patient groups (patients with and without chronic neuropsychiatric symptoms), voxels showing a significant difference in FA (P < .03) between groups were identified as reddish voxels on the FA template. The number of reddish voxels was greater in the region corresponding to the deep CWM, including the centrum semiovale, than in other regions.

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American Journal of Neuroradiology: 35 (4)
American Journal of Neuroradiology
Vol. 35, Issue 4
1 Apr 2014
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T. Beppu
The Role of MR Imaging in Assessment of Brain Damage from Carbon Monoxide Poisoning: A Review of the Literature
American Journal of Neuroradiology Apr 2014, 35 (4) 625-631; DOI: 10.3174/ajnr.A3489

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The Role of MR Imaging in Assessment of Brain Damage from Carbon Monoxide Poisoning: A Review of the Literature
T. Beppu
American Journal of Neuroradiology Apr 2014, 35 (4) 625-631; DOI: 10.3174/ajnr.A3489
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  • Article
    • Abstract
    • ABBREVIATIONS:
    • Mechanisms Causing Brain Damage after CO Exposure
    • Conventional MR Imaging
    • DWI and DTI
    • MR Spectroscopy
    • Current and Future
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