Asunto(s)
Antimetabolitos Antineoplásicos/efectos adversos , Capecitabina/efectos adversos , Carcinoma/secundario , Mielitis/etiología , Radiodermatitis/etiología , Radioterapia Adyuvante/efectos adversos , Neoplasias de la Columna Vertebral/secundario , Vértebras Torácicas , Antimetabolitos Antineoplásicos/uso terapéutico , Antineoplásicos Fitogénicos/uso terapéutico , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/radioterapia , Neoplasias de la Mama/cirugía , Capecitabina/uso terapéutico , Carcinoma/tratamiento farmacológico , Carcinoma/radioterapia , Carcinoma/cirugía , Terapia Combinada , Docetaxel/uso terapéutico , Sustitución de Medicamentos , Femenino , Humanos , Oxigenoterapia Hiperbárica , Letrozol/uso terapéutico , Persona de Mediana Edad , Mielitis/inducido químicamente , Mielitis/diagnóstico por imagen , Mielitis/terapia , Miositis/diagnóstico por imagen , Miositis/etiología , Prednisolona/uso terapéutico , Radiodermatitis/inducido químicamente , Radiodermatitis/diagnóstico por imagen , Radiodermatitis/terapia , Médula Espinal/efectos de la radiación , Neoplasias de la Columna Vertebral/radioterapiaRESUMEN
Delayed leukoencephalopathy is an uncommon complication of hypoxic-ischemic events of different etiologies, including carbon monoxide intoxication. We present a case of a 40-year-old male patient who was admitted with rapidly progressive neurocognitive and behavioral deficits. There was a history of accidental carbon monoxide intoxication one month before, presenting with loss of consciousness and short hospitalization, followed by a complete clinical recovery. The imaging studies in the delayed phase depicted confluent, symmetric supra-tentorial white matter lesions in keeping with diffuse demyelinization. Restricted diffusion and metabolite abnormalities in magnetic resonance proton spectroscopy were also seen. The diagnosis of CO-mediated delayed post-hypoxic leukoencephalopathy was assumed after exclusion of other mimickers. Hyperbaric oxygen therapy was tentatively performed and the patient had a favorable clinical and radiological evolution.