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Case No. 297
2013-03-04~2013-03-31
출제자 : 최현석
Hit : 447
| Period | 2013-03-04~2013-03-31 |
|---|---|
| Diagnosis | Delayed encephalopathy of Carbon Monoxide Poisoning |
| Clinical information | M/52 Mental change 진단은? |
| Discussion | Delayed encephalopathy of Carbon Monoxide Poisoning Affinity with Hb : CO >> oxygen CO-Hb impairs erythrocyte oxygen transport reducing cellular oxygen hypoxia Clinical presentation - Acute CO poisoning : n/v, headache, impaired consciousness, seizure - Delayed encephalopathy : Parkinson-like symtoms, memory deficits Treatment : Hyperbaric oxygen therapy Imaging * Necrosis of the Globus pallidus - Sensitive to hypoxia - CT : symmetric hypodensity - MR : low T1, high T2 SI, diffusion restriction, patchy/peripheral enhancement * The caudate nucleus, putamen, and thalamus : asymmetric hyperintense foci on T2WI * Hippocampus, corpus callosum, fornix, cerebral cortex * Delayed encephalopathy - Temporary asymptomatic period (lucid interval) of variable duration (2–3 weeks) after a recovery from the acute stage of CO intoxication - Demyelination of the cerebral white matter - the periventricular white matter and centrum semiovale - delayed and slowly progressive cytotoxic edema |
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Correct Answer
Semi-Correct Answer |