Abstract
Seven patients with an acute and severe carbon monoxide intoxication were treated with hyperbaric oxygen and underwent a positron emission tomographic examination 2–5 days after the acute event. Although the final clinical outcome was good in all patients, ischaemic changes were observed. Three patients with temporary sequelae after hyperbaric oxygen treatment showed the most severe changes, mainly in striatum and thalamus. Although positron emission tomographic examination cannot predict the final outcome, it can show the regions at risk for development of late complications following carbon monoxide poisoning.
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Altman DI, Lich LL, Powers WJ (1991) Brief inhalation method to measure cerebral oxygen extraction fraction with PET. Accuracy determination under pathologic conditions. J Nucl Med 32:1738–1741
Brown SD, Piantadosi CA (1990) In vivo binding of carbon monoxide to cytochrome C oxidase in rat brain. J Appl Physiol 68:604–610
Burney RE, Wu SC, Nemiroft MJ (1982) Mass carbon monoxide poisoning: clinical effects and results of treatment in 184 victims. Ann Emerg Med 11:394–399
Choi S (1983) Delayed neurologic sequelae in carbon monoxide intoxication. Arch Neurol 40:433–435
Coburn RF (1970) The carbon monoxide body stores. Ann NY Acad Sci 174:11–22
DeGroot H, Noll T (1987) The role of physiological oxygen partial pressures in lipid peroxidation. Theoretical considerations and experimental evidence. Chem Phys Lipids 44:209–226
DePoorter MC, Leys D, Godefroy O, DeReuck J, Petit H (1991) Syndrome parkinsonien post-oxycarboné. Résultats préliminaires du traitement par bromocriptine. Rev Neurol (Paris) 147:399–403
De Reuck J, Van Aken J, Petit H, Leys D, Lemahieu I, Strijckmans K (1990) Post-carbon monoxide leukoencephalopathy. Mechanisms of functional loss, reparation and its mechanisms of recovery after central nerve fibre damage. In: Von Wild K, Janzik HH (eds) Neurologische Frührehabilitation. Zuckschwerdt, Munich, pp 7–10
DeReuck J, Van Aken J, Decoo D, Petit H, Leys D, Lemahieu I, Strijckmans K (1991) Delayed neurological deterioration following acute carbon monoxide poisoning: comparison of clinical outcome, neuroimaging and positron emission tomography findings. Cerebrovasc Dis 1:273–290
Frackowiak RSJ, Lenzi GL, Jones T, Heather JD (1980) Quantitative measurement of regional cerebral blood flow and oxygen metabolism in man using150 and positron emission tomography: theory, procedure and normal values. J Comput Assist Tomogr 4:727–736
Garland H, Pearce J (1967) Neurological complications of carbon monoxide poisoning. Q J Med 36:445–455
Ginsberg R, Romano I (1976) Carbon monoxide encephalopathy: need for appropriate treatment. Am J Psychol 133:317–320
Gordon EB (1965) Carbon monoxide encephalopathy. BMJ 1:12–32
Jibiki I, Kurokawa K, Yamaguchi N (1991): 123 I-IMB Brain SPECT imaging in a patient with the interval form of CO poisoning. Eur Neurol 31:149–151
Kindwall EP (1977) Carbon monoxide and cyanide poisoning. In: Davies JD, Hunt TK (eds) Hyperbaric oxygen therapy. Undersea Med Soc, Bethesda, pp 177–190
Marklund SL (1985) Oxygen toxicity and protective systems. Clin Toxicol 23:289–298
Mathieu D, Nolf M, Durocher A, Saulnier F, Frimat P, Furon D, Wattel F (1985) Acute carbon monoxide poisoning. Risk of late sequelae and treatment by hyperbaric oxygen. Clin Toxicol 23:315–324
Min SK (1986) A brain syndrome associated with delayed neuropsychiatric sequelae following acute carbon monoxide intoxication. Acta Psychiatr Scand 73:80–86
Myers RAM, Britten JS (1989) Are arterial blood gases of value in treatment decisions for carbon monoxide poisoning? Crit Care Med 17:139–142
Myers RAM, Snijder SK, Emhoff TD (1985) Subacute sequelae of carbon monoxide poisoning. Ann Emerg Med 14:1163–1167
Okeda R, Funata N, Takano Y (1981) The pathogenesis of carbon monoxide encephalopathy in the acute phase: physical and morphological correlation. Acta Neuropathol (Berl) 54:1–10
Powers WJ, Grubb RL Jr, Raichle ME (1984) Physiological responses to focal cerebral ischemia in humans. Ann Neurol 16:546–552
Rosenthal M, Lamanne JC, Jobsis FF, Levasseur JE, Kontos HA, Patterson JL (1976) Effects of respiratory gases on cytochrome A in intact cerebral cortex. Is there a critical PO2? Brain Res 108:143–154
Smith J, Brandon S (1973) Morbidity from acute carbon monoxide poisoning at three year follow up. BMJ 1:318–321
Sokal JA (1975) Lack of correlation of biochemical effects on rats and blood carboxyhemoglobin concentration in various conditions of single acute exposure to carbon monoxide. Arch Toxicol 34:331–336
Starkstein S, Berthier ML, Leiguarde R (1989) Psychic akinesia following bilateral pallidal lesions. Int J Psychiatr Med 19:155–164
Tack E, De Renck J (1987) The use of bromocriptine in parkinsonism after carbon monoxide poisoning. Clin Neurol Neurosurg 89:275–279
Takano T, Miyazaki Y, Shimoyama H, Maeda H, Okeda R, Funata N (1981) Direct effects of carbon monoxide on cardiac function. Arch Occup Environ Health 49:3–40
Thom SR (1990) Carbon monoxide mediated brain lipid peroxidation in the rat. J Appl Physiol 68:997–1003
Thom SR (1990) Antagonism of carbon monoxide mediate brain lipid peroxidation by hyperbarie oxygen. Toxicol Appl Pharmacol 105:340–344
Thom SR, Keim LW (1989) Carbon monoxide poisoning: a review, epidemiology, pathophysiology, clinical findings and treatment options including hyperbaric oxygen therapy. Clin Toxicol 27:141–156
Urbanetti JS (1981) Carbon monoxide poisoning. Prog Clin Biol Res 51:335–385
Werner B, Bäck W, Akerblom H, Barr PO (1985) Two cases of acute carbon monoxide poisoning with delayed neurological sequelae after a “free” interval. Clin Toxicol 23:249–265
Weyne J, DeLey G, DeMeester G, Eeckhaute W (1987) PET studies of changes in cerebral blood flow and oxygen metabolism after unilateral microembolization of the brain in anaesthetized dogs. Stroke 18:128–137
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De Renck, J., Decoo, D., Lemahieu, I. et al. A positron emission tomography study of patients with acute carbon monoxide poisoning treated by hyperbaric oxygen. J Neurol 240, 430–434 (1993). https://doi.org/10.1007/BF00867357
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DOI: https://doi.org/10.1007/BF00867357