Clinical outcome and magnetic resonance imaging of carbon monoxide intoxication. A long-term follow-up study

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  • N. Pavese
  • A. Napolitano, University of Pisa
  • ,
  • G. De Laco, Ospedale S. Chiara
  • ,
  • R. Canapicchi, IRCCS Stella Maris, Ospedale S. Chiara
  • ,
  • P. L. Collavoli, Ospedale S. Chiara
  • ,
  • C. Lucetti, University of Pisa
  • ,
  • G. Gambaccini, University of Pisa
  • ,
  • U. Bonuccelli, University of Pisa

The clinical and neuroradiological outcome of carbon monoxide (CO) intoxication was evaluated prospectively in 30 patients over a follow-up period of 3 years. Among the patients studied, 22 had been acutely exposed to CO while 8 were chronically exposed. One month after CO poisoning, 12 of the 22 patients with acute intoxication showed magnetic resonance imaging (MRI) abnormalities: 6 also had neurological sequelae and 6 were asymptomatic. The remaining 10 patients showed neither MRI abnormalities nor neurological sequelae. During the 3-year follow-up, 4 of the patients with both MRI abnormalities and neurological sequelae improved in both clinical features and MRI findings. One of the 6 asymptomatic patients with MRI abnormalities developed a progressive cognitive impairment 2 months after acute intoxication, with a concomitant severe worsening of the MRI lesions. Among the 10 patients with neither MRI abnormalities nor neurological sequelae, only 1 developed neurological sequelae after a clear period of 4 months. In the group of patients who experienced chronic CO intoxication, only 1 presented with a neuropsychiatrie syndrome which improved at follow-up. Brain MRI showed white matter lesions which remained unchanged at control scan after 1 year. In conclusion, we observed that some patients with severe CO poisoning and neurological sequelae may fully regain normal functions after approximately 1 year. The presence of MRI lesions 1 month after CO poisoning did not accurately predict the subsequent outcome. The observation of a clear period longer than the usual 2-40 day interval in 2 patients should be considered for careful planning of follow-up and for prognosis in CO-poisoned patients.

Original languageEnglish
JournalItalian Journal of Neurological Sciences
Pages (from-to)171-178
Number of pages8
Publication statusPublished - 1 Jan 1999
Externally publishedYes

    Research areas

  • Carbon monoxide poisoning, Delayed neurologic sequelae, Magnetic resonance imaging

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