Jones J S, Lagasse J, Zimmerman G
Emergency Medicine Residency Program, Butterworth Hospital, Grand Rapids, MI.
Am J Emerg Med. 1994 Jul;12(4):448-51. doi: 10.1016/0735-6757(94)90059-0.
Selective necrosis and degeneration of the globus pallidus are characteristic autopsy findings in patients with severe carbon monoxide (CO) poisoning. The objective of this study was to show that computed tomography (CT) may demonstrate these morphological changes in the brain during life, and provide a clue to prognosis. The authors reviewed the medical records of 19 consecutive patients with acute CO poisoning who underwent CT examination during hospitalization. Abnormal CT findings were found in 10 of the 19 patients (53%). The most common abnormal findings were low-density areas in the basal ganglia. These lesions were found in 7 of the 10 cases, and varied from small (limited to the globus pallidus) to large (extending to the internal capsule). Of the 10 patients with abnormal CT scans, 9 survived to hospital discharge but all had some degree of functional neurological impairment. Eighty-nine percent (8 of 9) of the patients with normal CT scans were discharged neurologically intact. Awareness of the potential for basal ganglia lesions in CO poisoning should lead to more accurate CT interpretation and may have significant prognostic implications.
苍白球的选择性坏死和变性是重度一氧化碳（CO）中毒患者尸检的典型发现。本研究的目的是表明计算机断层扫描（CT）可以在患者生前显示脑部的这些形态学变化，并为预后提供线索。作者回顾了19例住院期间接受CT检查的急性CO中毒患者的病历。19例患者中有10例（53%）发现CT异常。最常见的异常表现是基底节区低密度灶。10例中有7例发现这些病变，大小不一，小的（局限于苍白球）到大的（延伸至内囊）。10例CT扫描异常的患者中，9例存活至出院，但均有一定程度的功能性神经损伤。CT扫描正常的患者中89%（9例中的8例）神经功能完整出院。认识到CO中毒时基底节区病变的可能性应能使CT解释更准确，并可能对预后有重要意义。
