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因燃气热水器综合征导致急性一氧化碳中毒后的急性皮质盲

Acute Cortical Blindness Following Acute Carbon Monoxide Intoxication Due to Gas Geyser Syndrome.

作者信息

Pandey Nirmal, Nigam Saket

机构信息

Neurology, Regency Hospital, Kanpur, IND.

Radiology, Regency Hospital, Kanpur, IND.

出版信息

Cureus. 2024 Sep 28;16(9):e70408. doi: 10.7759/cureus.70408. eCollection 2024 Sep.

Abstract

Accidental carbon monoxide (CO) poisoning is common during the winters. The use of gas geysers by Indian households during this season for heating purposes may inadvertently lead to brain injury. Such cases can be misdiagnosed as seizures, resulting in inappropriate treatment. Typically, CO poisoning results in bilateral damage to the globus pallidus, while injury to the cortical gray matter is less common. A magnetic resonance imaging (MRI) of the brain done within the first 24 hours might not detect all the damage, so it's important to have a follow-up MRI within 3-7 days for a more accurate assessment. Our case presents a unique instance of CO poisoning where the patient exhibited near-symmetric posterior gray matter damage, without involvement of the basal ganglia, resulting in acute cortical blindness following exposure to a gas geyser. The awareness of this unusual and peculiar clinical and radiological presentation in gas geyser-related cases should encourage clinicians to adopt a more proactive approach.

摘要

冬季意外一氧化碳(CO)中毒很常见。在此季节,印度家庭使用燃气热水器取暖可能会意外导致脑损伤。此类病例可能被误诊为癫痫发作,从而导致治疗不当。通常,CO中毒会导致双侧苍白球受损,而皮质灰质损伤则较少见。在最初24小时内进行的脑部磁共振成像(MRI)可能无法检测到所有损伤,因此在3 - 7天内进行随访MRI以进行更准确的评估很重要。我们的病例呈现了一例独特的CO中毒情况,患者表现为近乎对称的后部灰质损伤,基底节未受累,在接触燃气热水器后导致急性皮质盲。对于与燃气热水器相关病例中这种不寻常且特殊的临床和放射学表现的认识,应促使临床医生采取更积极主动的方法。

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