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Case Reports
. 2021 Sep 6;13(9):e17772.
doi: 10.7759/cureus.17772. eCollection 2021 Sep.

Bilateral Cerebral Hemorrhagic Infarctions: An Early Presentation of Carbon Monoxide Poisoning

Raima Kaleemi  1 , Shayan S Anwar  1 , Anwar Ahmed  1
Affiliations
Case Reports

Bilateral Cerebral Hemorrhagic Infarctions: An Early Presentation of Carbon Monoxide Poisoning

Raima Kaleemi et al. Cureus. .

Abstract

Carbon monoxide (CO) poisoning is one of the most common causes of morbidity secondary to accidental or intentional exposure. It is a potentially life-threatening disease. We present the case of a 23-year-old male patient who slept with a gas generator the whole night in a closed room. The next morning the patient presented to emergency with altered mentation. His Glasgow Coma Scale score was 8/15 on arrival. The patient had cerebral hemorrhages on presentation with diffuse cerebral hypoxic injury and bilateral globus pallidus signals. Hemorrhagic infarction in the brain is a rare presentation of CO poisoning and even rarer as an early manifestation of this disease. We present a case of bilateral posterior cerebral hemorrhagic infarctions with a diffuse hypoxic insult as an early presentation of CO poisoning in a young male, which to our knowledge has rarely been reported. Early imaging and prompt medical attention can be life-saving.

Keywords: carbon monoxide poisoning; globus pallidus; hemorrhagic infarcts; hypoxic injury; magnetic resonance imaging; white matter demyelination.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Multiplanar and multisequential MRI of the brain.
A & B: T1 axial image showing T1 hyperintense signal in the globus pallidus (red arrow, typical finding of CO poisoning) and hemorrhage in the posterior parietal regions involving the gray-white matter junction and watershed areas (black arrow). C: T2 axial image showing abnormal T2 hyperintense signals in the subcortical white matter, centrum semiovale (green arrow), and hemorrhage in the posterior parietal regions (black arrow). D: T2 axial image showing T2 hyperintense signal in the globus pallidus (red arrow). E: FLAIR coronal image redemonstrating abnormal white matter signals. F: SWI showing signal dropout in the bilateral globus pallidus and posterior occipital region, more on the right (red arrow). CO: carbon monoxide; FLAIR: fluid-attenuated inversion recovery; MRI: magnetic resonance imaging; SWI: susceptibility-weighted imaging
See this image and copyright information in PMC

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