Hemorrhagic cerebral infarction in carbon monoxide poisoning: a case report

Almost every known central neurological syndrome has been reported as a complication of carbon monoxide poisoning. Hemorrhagic infarct has rarely been considered as an early manifestation of carbon monoxide poisoning. A case of cerebral hemorrhagic infarction is presented. Typical findings, neuropathology and the role of vascular injury are described.

The symptoms and clinical course of acute poisoning with carbon monoxide in a 7-year-old boy are described. To evaluate the possible causes, a brain computed tomography (CT) was performed that showed thick clot in the left medial temporal and parasellar area, left sylvian fissure (acute intravascular thrombus) accompanied by left diffuse frontotemporal hypodensity and midline shift. Four-vessel digital subtraction angiography two weeks after intoxication was not indicative of any vascular lesion.

Hemorrhagic infarction is a rare presentation of carbon monoxide poisoning. When found in a child, in addition to conservative treatment to reduce the neurocognitive squeal, other probable causes should be ruled out.