Reversal of a Globus Pallidus Injury in a Severe Carbon Monoxide Poisoned Patient

Carbon monoxide (CO) is an important source of poisoning in the United States and accounts for over 50,000 emergency department (ED) visits annually. Of these, almost 15,000 cases are reported as intentional, with over 1,000 deaths annually reported in the USA.1 Unintentional deaths from carbon monoxide poisoning are commonly associated with the improper use of generators, heaters, or other sources of combustion, such as malfunctioning home appliances or vehicular exhaust [2,3]. We describe a case of severe intentional CO poisoning that had reversal of CT and MRI findings that were consistent with a globus pallidus injury and a favorable clinical outcome in an adult male treated with Hyperbaric Oxygen Therapy (HBO₂). There are currently conflicting data and guideline recommendations regarding the utility of HBO₂ in the management of CO.4 This case provides additional evidence for HBO₂ treatment in a patient population whose clinical presentation and imaging findings are consistent with severe poisoning.