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一氧化碳中毒所致出血性脑梗死:一例报告

Hemorrhagic cerebral infarction in carbon monoxide poisoning: a case report.

作者信息

El Khashab Mostafa, Nejat Farideh

机构信息

Department of Neurosurgery, Hackensack University Medical Center, New Jersey, USA.

出版信息

Cases J. 2009 Jan 29;2:96. doi: 10.1186/1757-1626-2-96.

Abstract

INTRODUCTION

Almost every known central neurological syndrome has been reported as a complication of carbon monoxide poisoning. Hemorrhagic infarct has rarely been considered as an early manifestation of carbon monoxide poisoning. A case of cerebral hemorrhagic infarction is presented. Typical findings, neuropathology and the role of vascular injury are described.

CASE PRESENTATION

The symptoms and clinical course of acute poisoning with carbon monoxide in a 7-year-old boy are described. To evaluate the possible causes, a brain computed tomography (CT) was performed that showed thick clot in the left medial temporal and parasellar area, left sylvian fissure (acute intravascular thrombus) accompanied by left diffuse frontotemporal hypodensity and midline shift. Four-vessel digital subtraction angiography two weeks after intoxication was not indicative of any vascular lesion.

CONCLUSION

Hemorrhagic infarction is a rare presentation of carbon monoxide poisoning. When found in a child, in addition to conservative treatment to reduce the neurocognitive squeal, other probable causes should be ruled out.

摘要

引言

几乎每一种已知的中枢神经系统综合征都曾被报道为一氧化碳中毒的并发症。出血性梗死很少被认为是一氧化碳中毒的早期表现。本文介绍了一例脑出血性梗死病例。描述了其典型表现、神经病理学及血管损伤的作用。

病例报告

描述了一名7岁男孩急性一氧化碳中毒的症状和临床过程。为评估可能的病因,进行了脑部计算机断层扫描(CT),结果显示左颞内侧和鞍旁区域、左外侧裂有浓稠血栓(急性血管内血栓),伴有左侧弥漫性额颞叶低密度影和中线移位。中毒两周后进行的四血管数字减影血管造影未显示任何血管病变。

结论

出血性梗死是一氧化碳中毒的罕见表现。当在儿童中发现时,除了采取保守治疗以减少神经认知后遗症外,还应排除其他可能的病因。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fabe/2649056/42cdfdd99b4f/1757-1626-2-96-1.jpg

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