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Case Reports
. 2002 Sep;23(8):1398-401.

MR changes after acute cyanide intoxication

Johanna Rachinger  1 , Franz A Fellner, Karl Stieglbauer, Johannes Trenkler
Affiliations
Case Reports

MR changes after acute cyanide intoxication

Johanna Rachinger et al. AJNR Am J Neuroradiol. 2002 Sep.

Abstract

We describe MR changes that occurred 3 and 6 weeks after a suicide attempt with cyanide. The toxicity of cyanide causes damage, primarily to the basal ganglia, and those changes were visible as altered signal intensity on the first MR images. Extensive areas of hemorrhagic necrosis were seen 6 weeks later. Our case shows pseudolaminar necrosis along the central cerebral cortex 3 weeks after cyanide poisoning, showing that the sensorimotor cortex is also a site for toxic necrosis because of its high oxygen dependency.

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Figures

F<sc>ig</sc> 1.
Fig 1.
Follow-up MR images obtained 3 weeks after cyanide poisoning. A, Fluid-attenuated inversion recovery (9000/110 [TR/TE]) image. Discrete hyperintense linear signals can be seen along the sensorimotor cortex. B, T1-weighted (550/14) image obtained before the administration of contrast agent. C, T1-weighted (715/17) image obtained after the administration of contrast agent. Massive contrast enhancement can be seen along the central region, consistent with pseudolaminar necrosis. D, Fluid-attenuated inversion recovery (9000/110) image. Discrete hyperintense signals can be seen in the caudate nuclei bilaterally. E, Unenhanced T1-weighted (550/14) image shows hyperintense signals in the caudate nuclei bilaterally, consistent with hemorrhage. F, T1-weighted (715/17) image obtained after administration of contrast agent. Massive contrast enhancement can be seen in the lentiform nuclei and the caudate nuclei bilaterally.
F<sc>ig</sc> 2.
Fig 2.
Follow-up MR images obtained 6 weeks after cyanide poisoning. A and B, T2-weighted (2660/90) images. The hyperintense signal changes in the basal ganglia are considerably more pronounced. C and D, T1-weighted (550/14) unenhanced images. Hemorrhagic necrosis can be seen in the sensorimotor cortex (C) and the basal ganglia (D). E and F, T1-weighted (715/17) images obtained after administration of contrast agent. Pronounced contrast enhancement can be seen along the central cortex (E) and the basal ganglia (F).
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