COgnitive crisis: unveiling neurological consequences of carbon monoxide poisoning: a case report

Ashish  Behera; Abhishek  Kumar; Ritin  Mohindra; Alaipreet  Kaur; Bodhibrata  Banerjee; Bhuranjana  Baghel

doi:10.18502/fem.v9i2.19199

Ashish Behera Department of Internal Medicine, Post Graduate Institute of Medical Research and Education, Chandigarh, India.
Abhishek Kumar Department of Radiodiagnosis, Post Graduate Institute of Medical Research and Education, Chandigarh, India.
Ritin Mohindra Department of Internal Medicine, Post Graduate Institute of Medical Research and Education, Chandigarh, India.
Alaipreet Kaur Department of Radiodiagnosis, Post Graduate Institute of Medical Research and Education, Chandigarh, India.
Bodhibrata Banerjee Department of Internal Medicine, Post Graduate Institute of Medical Research and Education, Chandigarh, India.
Bhuranjana Baghel Department of Internal Medicine, Post Graduate Institute of Medical Research and Education, Chandigarh, India.

DOI: https://doi.org/10.18502/fem.v9i2.19199

Keywords: Brain Changes; Carbon Monoxide Poisoning; Hyperbaric Oxygen Therapy; MRI; Neuroimaging; Toxic Encephalopathy,

Abstract

Carbon Monoxide (CO) is commonly emitted by vehicles, industrial processes, and heating systems. It can lead to unintentional poisoning in enclosed spaces. Common findings include tachycardia, hypotension, hypoxemia, headache, dizziness, seizures, or coma. A thorough history is essential to suspect potential CO poisoning. Confirmatory tests include measuring carboxyhemoglobin levels in blood. The first step of management is to remove the patient from the source, followed by oxygen supplementation. In severe cases, hyperbaric oxygen therapy may be indicated. Prognosis depends on the level of exposure, as well as the promptness of treatment. Early intervention leads to better outcomes. Delayed neurological deficits are potential long-term outcomes. Prognosis for recovery improves significantly with the use of CO detectors in homes and education about the risks of CO exposure.

We present a case of a 15-year-old male who presented with acute encephalopathy. Upon physical examination, laboratory study, and neuroimaging, a diagnosis of CO poisoning was made. The patient was intubated, placed on a ventilator, and managed conservatively with remarkable recovery.