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Rationale:
- Neuroimaging scans in the form of CT or MRI can show changes consistent with cell death in basal ganglia and watershed areas,
which highly suggest severe CO intoxication.
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Evidence:
- Case series of CO-poisoned patients studied with CT in 19 patients (35) showed abnormal low-density lesions in the basal ganglia in 10 patients, whereas 2 of 2 patients studied with MRI (36) showed edema in the basal ganglia.
- In a case series of 40 patients, normal CT scans correlated with complete recovery after HBOT, whereas any abnormalities predicted
incomplete neurologic recovery or death (37).
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Comments:
- Neuropsychologic testing should not be used as a standard diagnostic tool for CO toxicity, except as a research tool or in
centers with psychologists experienced in the diagnosis of CO poisoning.
- Although neuropsychologic testing results were abnormal in a series of 8 patients (38), it is not specific for CO poisoning and did not predict benefit of HBOT (39) in a series of 48 patients.
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Jeffrey T. Chapman, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Darren B. Taichman, MD, PhD, Editor, PIER, has received grant support from Actelion Pharmaceuticals Ltd , and honoraria for
continuing medical education grand rounds and lectures given.
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for clinical judgment and does not represent an official position of
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PIER is copyrighted (c) 2010 by the American College of Physicians,
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Carbon Monoxide Poisoning
> Diagnosis
