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氰化物中毒幸存者出现动脉化后的长期神经精神后遗症。

Long-Term Neuropsychiatric Sequelae in a Survivor of Cyanide Toxicity Patient With Arterialization.

作者信息

Alqahtani Rakan M, Alyousef Mohammed Yousef, AlWatban Zaki Hassan, Ghandour Mohammed Khaled

机构信息

Critical Care, College of Medicine, King Saud University, Riyadh, SAU.

出版信息

Cureus. 2020 Jun 3;12(6):e8430. doi: 10.7759/cureus.8430.

Abstract

Cyanide is one of the most rapidly acting poisons and accounts for many suicidal and homicidal deaths. Some natural products such as silk and wool can release cyanide when burned. Most patients who survive cyanide poisoning experience neurological sequelae. This report describes the case of a healthy 45-year-old Yemeni woman who was present during the burning of furniture in a closed space in her home. Upon admission, she displayed signs of inhalational injury, a black discoloration around her mouth and nostrils, and a first-degree burn on the left side of her neck. She experienced neuropsychiatric sequelae of cyanide poisoning, with deficits evolving over three months. Even after three months of treatment and continuous follow-up, she still showed signs of mild cognitive memory impairment along with word-finding difficulties and focal dystonia of her right hand. Full neurological and cognitive assessments are crucial to determine the neuropsychiatric sequelae of acute cyanide toxicity. Magnetic resonance imaging (MRI) can show the extent and structure of lesions in cyanide-sensitive regions of the brain, but it is not always diagnostic. The arterialization of venous blood gases may serve as an early clue to the diagnosis of cyanide poisoning.

摘要

氰化物是作用最快的毒物之一,导致许多自杀和他杀死亡事件。一些天然产物,如丝绸和羊毛,燃烧时会释放氰化物。大多数氰化物中毒幸存者会出现神经后遗症。本报告描述了一名45岁健康也门女性的病例,她在家中封闭空间内家具燃烧时在场。入院时,她表现出吸入性损伤的迹象,口周和鼻孔周围有黑色变色,颈部左侧有一度烧伤。她出现了氰化物中毒的神经精神后遗症,症状在三个月内逐渐发展。即使经过三个月的治疗和持续随访,她仍表现出轻度认知记忆障碍的迹象,伴有找词困难和右手局灶性肌张力障碍。全面的神经和认知评估对于确定急性氰化物中毒的神经精神后遗症至关重要。磁共振成像(MRI)可以显示大脑氰化物敏感区域病变的范围和结构,但并不总是具有诊断性。静脉血气动脉化可能是氰化物中毒诊断的早期线索。

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