Vaio Hospital, 43036 Fidenza, Italy.
Casa di Cura HABILITA I Cedri, 28073 Fara Novarese, Italy.
Int J Environ Res Public Health. 2022 Apr 27;19(9):5300. doi: 10.3390/ijerph19095300.
Carbon Monoxide (CO) intoxication is still a leading cause of mortality and morbidity in many countries. Due to the problematic detection in the environment and subtle symptoms, CO intoxication usually goes unrecognized, and both normobaric and hyperbaric oxygen (HBO) treatments are frequently administered with delay. Current knowledge is mainly focused on acute intoxication, while Delayed Neurological Sequelae (DNS) are neglected, especially their treatment. This work details the cases of two patients presenting a few weeks after CO intoxication with severe neurological impairment and a characteristic diffused demyelination at the brain magnetic resonance imaging, posing the diagnosis of DNS. After prolonged treatment with hyperbaric oxygen, combined with intravenous corticosteroids and rehabilitation, the clinical and radiological features of DNS disappeared, and the patients' neurological status returned to normal. Such rare cases should reinforce a thorough clinical follow-up for CO intoxication victims and promote high-quality studies.
一氧化碳（CO）中毒仍然是许多国家导致死亡率和发病率的主要原因。由于在环境中难以检测到 CO，且症状较为隐匿，CO 中毒常常未被识别，常压和高压氧（HBO）治疗也经常延迟。目前的知识主要集中在急性中毒上，而迟发性神经后遗症（DNS）则被忽视，尤其是它们的治疗。本工作详细介绍了两名患者的病例，他们在 CO 中毒后数周出现严重的神经功能障碍和大脑磁共振成像上特征性的弥散性脱髓鞘，提示诊断为 DNS。经过高压氧、静脉注射皮质类固醇和康复治疗的长期治疗后，DNS 的临床和放射学特征消失，患者的神经状态恢复正常。这些罕见的病例应加强对 CO 中毒患者的彻底临床随访，并促进高质量的研究。
