However, the pathogenesis of DEACMP remains unclear. DEACMP usually presents as a series of neuropsychiatric symptoms and signs, typically dementia, after a false recovery lasting 2–60 days, following acute carbon monoxide poisoning. Delayed encephalopathy after acute carbon monoxide poisoning (DEACMP) is a common complication of the central nervous system following carbon monoxide poisoning. KeywordsĬarbon monoxide poisoning, Delayed neuropsychiatric sequelae, Magnetic resonance imaging, Clinical characteristics IntroductionĪcute carbon monoxide poisoning is a common poisoning related to occupational exposure or occurring in daily life, and it is more frequent in the rural areas of North China where current heating measures are antiquated. Laboratory tests including serum CRP and D-dimer levels can aid in the diagnosis of DEACMP. Cerebral infarction may precede any white matter lesions. Moreover, the signal abnormalities of the bilateral symmetrical globus pallidus lesions are not pronounced in the subacute stage and, therefore, may be easily neglected. Therefore, the patient was finally diagnosed with DEACMP.Įarly MRI findings of DEACMP may include atypical and asymmetric white matter lesions. According to clinical and radiological process, radiologist inquired the patient’s history, he admitted to having an explicit history of CO exposure. A normal CRP level was basically restored per a routine blood test, and the D-dimer level increased to 3580 ng/ml. Then he had another MRI scan, which revealed symmetrical signal abnormalities in the basal ganglia regions bilaterally and white matter around the posterior and anterior horns of lateral ventricles bilaterally. However, the symptoms were aggravated after lowering the hormone dose. Based on clinical manifestations, a preliminary diagnosis of autoimmune encephalitis was made, and the patient’s conditions improved after symptomatic treatment. MRI scan revealed enlargement of the lesion in the right centrum semiovale, as well as new lesions in the bilateral parietal and occipital lobes. After admission, the patient underwent symptomatic treatment and reexamination, and a routine blood test revealed an increased CRP level and a decreased D-dimer level. He was initially diagnosed with cerebral infarction according to radiologic findings. A MRI scan of the brain indicated abnormal signals in the left thalamus and right centrum semiovale, along with mild abnormal signals in the bilateral symmetrical globus pallidus lesions (unfortunately, this sign was overlooked). This patient had a normal C-reactive protein (CRP) level but an increased D-dimer level upon admission. Radiologic and clinical data from this case of DEACMP were reviewed. To analyze retrospectively one case of delayed encephalopathy after acute carbon monoxide poisoning (DEACMP) that demonstrated both clinical and radiological progression and to summarize the experiences learned from the treatment of this case. Shuang-Shuang Song, Ying Li, Lei Niu, Song Liu, Chong-Feng Duan, Qing-Lan Sui, Ji-Ping Zhao, Yan-De Ren and Xue-Jun Liu *ĭepartment of Radiology, the Affiliated Hospital of Qingdao University, Qingdao, China Corresponding Author: Xue-Jun Liuĭepartment of Radiology, the Affiliated Hospital of Qingdao University, Qingdao, China
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