Brain CT-Scan Findings in Unconscious Patients after Poisoning

Abstract

The aim of this study was to identify and describe brain CT findings in patients with poisoning or drug overdose and altered mental status. In this study, 403 patients with some degree of loss of consciousness who referred due to poisoning or drug overdose were evaluated by brain CT. The most common cause of intoxication was suicide. Intoxication status was determined by the physician and was mainly based on a history of intoxication, positive toxicologic screen result, or physical evidence suggesting intoxication. Among 403 unconscious patients, 229 patients who were ingested or inhaled Benzodiazepine, Carbamazepine, Carbon Monoxide, Ethanol, Methanol, Opium, Tricyclic antidepressants, and Tramadol included in the study. Others had used multiple drugs and/or toxins, or their intoxication was unknown. Mean age of patients was 37.6 ± 17.7 years (14-95). Among them, 181 (79%) were male. Among all patients, 92 had consumed opium (40.2%), 47 had consumed Benzodiazepines (20.5%) and other patients had been overdosed by other drugs or exposed to other poisonous agents. Totally 38 (16.5%) patients had abnormal CT findings. These included 10 cases of infarction, four cases of hemorrhage, two cases of herniation, 13 cases of edema, and 10 cases of basal ganglia changes (including 9 cases of hypodensity and one case of hypodensity with hemorrhage). A good knowledge of the CT findings in unconscious patients due to poisoning or drug overdose seems to be necessary for radiologists and clinicians. This study is unique in that it reported most of the radiological findings in these patients.

Keywords: brain; computed tomography; neuroimaging; poisoning.