CT of the brain in acute carbon monoxide intoxication: characteristic features and prognosis

Of 60 patients with acute carbon monoxide (CO) intoxication caused by accidental or intentional inhalation of natural gas, smoke inhalation, or inhalation of automobile exhaust, 23 had characteristic computed tomographic findings. The most common finding, seen in 21 patients, was symmetric and diffuse low density in the cerebral white matter, which was more advanced in the centrum semiovale and varied in degree from slight to severe. In 18 patients there was a symmetric, bilateral, round low-density lesion in the globus pallidus. The size of the lesion varied from small (limited to the globus pallidus) to large (extension to the internal capsule). Of the 23 patients, six made a good recovery, four recovered with some disabilities, eight remained in a vegetative state, and five died. The prognosis depended on the severity of the cerebral white-matter changes and not on the size of the low-density lesion of the globus pallidus.