Research Article| Volume 160, ISSUE 1, P87-91, September 18, 1998

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Magnetic resonance imaging and 11C-N-methylspiperone/positron emission tomography studies in a patient with the interval form of carbon monoxide poisoning


      Magnetic resonance (MR) and 11C-N-methylspiperone (11C-NMSP)/positron emission tomography (PET) imagings were repeatedly performed in a 50-year-old man with the interval form of carbon monoxide (CO) poisoning. In MR images obtained when delayed neuropsychiatric symptoms developed (two months after poisoning), the inner segments of the bilateral globus pallidus appeared as high signal intensities in the T1-weighted and low signal intensities in the T2-weighted images, suggesting prior focal hemorrhage in these areas. A PET study with 11C-NMSP performed at that time showed an increase in dopamine D2 receptor binding in the caudate and putamen. Treatment with bromocriptine was very effective and five months after the poisoning, MR and 11C-NMSP/PET images showed improvement, concomitantly with the disappearance of the neuropsychiatric symptoms.


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        • Auer R.N
        • Siesjö B.K
        Biological differences between ischemia, hypoglycemia, and epilepsy.
        Ann Neurol. 1988; 24: 699-707
        • Bergström M
        • Litton J
        • Eriksson L
        • Bohm C
        • Blomqvist G
        Determination of object contour from projections for attenuation correction in cranial positron emission tomography.
        J Comput Assisted Tomogr. 1982; 6: 365-372
        • Bianco F
        • Floris R
        MRI appearances consistent with haemorrhagic infarction as an early manifestation of carbon monoxide poisoning.
        Neuroradiology. 1996; 38: S70-S72
        • Chang K.H
        • Han M.H
        • Kim H.S
        • Wie B.A
        • Han M.C
        Delayed encephalopathy after acute carbon monoxide intoxication: MR imaging features and distribution of cerebral white matter lesions.
        Radiology. 1992; 184: 117-122
        • De Poorter M.C
        • Leys D
        • Godefroy O
        • De Reuck J
        • Petit H
        Syndrome parkinsonien post-oxycarboné. Résultats préliminaires du traitement par bromocriptine.
        Rev Neurol (Paris). 1991; 147: 399-403
        • De Reuck J
        • Decoo D
        • Lemahieu I
        • Strijckmans K
        • Boon P
        • Van Maele G
        • Buylaert W
        • Leys D
        • Petit H
        A positron emission tomography study of patients with acute carbon monoxide poisoning treated by hyperbaric oxygen.
        J Neurol. 1993; 240: 430-434
        • Hägglund J
        • Aquilonius S.-M
        • Eckernäs S.-Å
        • Hartvig P
        • Lundquist H
        • Gullberg P
        • Långström B
        Dopamine receptor properties in Parkinson's disease and Huntington's chorea evaluated by positron emission tomography using 11C-N-methyl-spiperone.
        Acta Neurol Scand. 1987; 75: 87-94
        • Horowitz A.L
        • Kaplan R
        • Sarpel G
        Carbon monoxide toxicity: MR imaging in the brain.
        Radiology. 1987; 162: 787-788
        • Jibiki I
        • Kurokawa K
        • Yamaguchi N
        123I-IMP brain SPECT imaging in a patient with the interval form of CO poisoning.
        Eur Neurol. 1991; 31: 149-151
        • Lapresle J
        • Fardeau M
        The central nervous system and carbon monoxide poisoning. II. Anatomical study of brain lesions following intoxication with carbon monoxide (22 cases).
        Prog Brain Res. 1967; 24: 31-74
        • Lowe-Ponsford F.L
        • Henry J.A
        Clinical aspects of carbon monoxide poisoning.
        Adverse Drug React. Acute Poisoning Rev. 1989; 8: 217-240
        • Momose T
        • Sasaki Y
        Striatal dopamine D2 receptor in Parkinson disease and its related disorders assessed by 11C-NMSP and PET.
        Nippon Rinsho. 1997; 55: 227-232
        • Norkool D.M
        • Kirkpatrick J.N
        Treatment of acute carbon monoxide poisoning with hyperbaric oxygen: a review of 115 cases.
        Ann Emerg Med. 1985; 14: 1168-1171
      1. Schochet SS Jr, Nelson J. Exogenous toxic–metabolic diseases including vitamin deficiency. Carbon monoxide. In: Davis RL, Robertson DM, editors. Textbook of neuropathology. Third ed. Baltimore: Williams and Wilkins, 1997:512–4.

        • Silverman C.S
        • Brenner J
        • Murtagh F.R
        Hemorrhagic necrosis and vascular injury in carbon monoxide poisoning: MR demonstration.
        Am J Neuroradiol. 1993; 14: 168-170
        • Starkstein S.E
        • Berthier M.L
        • Leiguarda R
        Psychic akinesia following bilateral pallidal lesions.
        Int J Psychiatr Med. 1989; 19: 155-164
        • Tack E
        • De Reuck J
        The use of bromocriptine in parkinsonism after carbon monoxide poisoning.
        Clin Neurol Neurosurg. 1987; 89: 275-279
        • Tom T
        • Abedon S
        • Clark R.I
        • Wong W
        Neuroimaging characteristics in carbon monoxide toxicity.
        J Neuroimaging. 1996; 6: 161-166