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Delayed leukoencephalopathy after acute carbon monoxide intoxication

2014; EduRad Publishing; Volume: 8; Issue: 5 Linguagem: Inglês

10.3941/jrcr.v8i5.1721

1943-0922

Ana Filipa Geraldo, Cristiana Silva, Dulce Neutel, Lia Lucas Neto, Luí­sa Albuquerque,

Neurological and metabolic disorders

Delayed leukoencephalopathy is an uncommon complication of hypoxic-ischemic events of different etiologies, including carbon monoxide intoxication. We present a case of a 40-year-old male patient who was admitted with rapidly progressive neurocognitive and behavioral deficits. There was a history of accidental carbon monoxide intoxication one month before, presenting with loss of consciousness and short hospitalization, followed by a complete clinical recovery. The imaging studies in the delayed phase depicted confluent, symmetric supra-tentorial white matter lesions in keeping with diffuse demyelinization. Restricted diffusion and metabolite abnormalities in magnetic resonance proton spectroscopy were also seen. The diagnosis of CO-mediated delayed post-hypoxic leukoencephalopathy was assumed after exclusion of other mimickers. Hyperbaric oxygen therapy was tentatively performed and the patient had a favorable clinical and radiological evolution.