Assessment of Functional Disturbances in the Central Nervous System Caused by Severe Carbon Monoxide Poisoning in Rats.

An experimental model was developed for assessment of disturbances in CNS functions of laboratory animals caused by severe carbon monoxide poisoning. Normalization of the state of experimental rats after acute poisoning was accompanied by the development of cognitive abnormalities. Disturbances in the long-term memory were observed on days 1 and 14 after CO poisoning, while abnormalities in the short-term memory developed on days 1, 7, and 14. Learning impairment were recorded on day 8, while the training course began on day 7.

The role of MR imaging in assessment of brain damage from carbon monoxide poisoning: a review of the literature.

SUMMARY: The aim of this article is to review how MR imaging and associated imaging modalities provide clinicopathologic information on brain damage after carbon monoxide poisoning. Initially, many authors documented typical findings of conventional MR imaging in the gray matter structures such as the globus pallidus and in various regions of cerebral white matter. The focus of investigation has since shifted to observation of cerebral white matter areas that are more frequently detected on MR imaging and are more responsible for chronic symptoms than the gray matter. DWI has dramatically contributed to the ability to quantitatively assess cerebral white matter damage. Subsequently, DTI has enabled more sensitive evaluation than DWI and can demonstrate progressive pathologic changes in the early stage, allowing prediction of chronic conditions. In addition, MR spectroscopy reveals changes in metabolite levels, offering quantitative clinicopathologic information on brain damage after carbon monoxide poisoning.

Assessment of damage to cerebral white matter fiber in the subacute phase after carbon monoxide poisoning using fractional anisotropy in diffusion tensor imaging.

INTRODUCTION: Chronic neuropsychiatric symptoms after carbon monoxide (CO) poisoning are caused by demyelination of cerebral white matter fibers. We examined whether diffusion tensor imaging can sensitively represent damage to fibers of the centrum semiovale in the subacute phase after CO intoxication. METHODS: Subjects comprised 13 adult patients with CO poisoning, classified into three groups according to clinical behaviors: group A, patients with transit acute symptoms only; group P, patients with persistent neurological symptoms; and group D, patients with "delayed neuropsychiatric sequelae" occurring after a lucid interval. Median fractional anisotropy (FA) and apparent diffusion coefficient (ADC) of the centrum semiovale bilaterally at 2 weeks were compared between these groups and a control group of ten healthy volunteers. Myelin basic protein (MBP) concentration in cerebrospinal fluid was examined at 2 weeks to evaluate the degree of demyelination in patients. RESULTS: MBP concentration was abnormal or detectable for all group P and group D patients but was undetectable for all patients assigned to group A. Low FA values in groups P and D displaying chronic neurological symptoms clearly differed from those in controls and group A without chronic neurological symptoms, but ADC showed no significant differences between patient groups. CONCLUSIONS: MBP concentration at 2 weeks after CO inhalation confirmed a certain extent of demyelination in the central nervous system of patients who would develop chronic neurological symptoms. In these patients, FA sensitively represented damage to white matter fibers in the centrum semiovale in the subacute phase after CO intoxication.

[Late fatality after CO poisoning]. / Spät-Todesfall nach CO-Intoxikation.

The report involves a 57-year-old man who was released from in-patient treatment relatively free of complaints 3 days after an attempted suicide with carbon monoxide. After a trouble-free interval, however, more and more organic brain symptoms accompanied by spasms appeared. In the end, the patient died 2 months later of an intermittent fulminating terminal embolism of the pulmonary artery with a thrombosis in the veins of the lower extremities. The clinical course and the anatomicopathological findings are discussed from the pathophysiological point of view. The question of a causal relationship between the "attempted suicide and lethal outcome" had to be answered in the affirmative as regards the insurance law aspects.

Early acute fatal carbon monoxide poisoning--assessment of the survival period.

While the postmortem appearances and laboratory diagnosis of carbon monoxide poisoning are well recognized, the problem of determining the length of survival and hence the possible time of death still exists. The haematoxylin-basic fuchsin-picric acid stain for the detection of early myocardial ischaemia was applied in an attempt to assess the length of survival in early acute fatal carbon monoxide poisoning. Although the value of this stain in elucidating early ischaemia was confirmed, its application to this specific problem in forensic medicine appears limited.