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[Dynamic aspect of brain edema in cases of acute carbon-monoxide poisoning (author's transl)]
Abstract:
Eleven cases of acute carbon-monoxide poisoning in various stages were observed with the computerized tomography for 17 times and analysed their correlation between intracranial lesion and their clinical courses. Five of 11 cases revealed characterististic pathologic findings in CT scan, however complete recovery of consciousness was observed in only 4 of 6 cases with normal CT findings. In early stage of acute carbon-monoxide poisoning, CT scans showed typical diffuse subcortical low absorption with no obvious ventricular dilatation. The entity of this typical finding was supposed to be the so called "vasogenic edema" attributed to increased extracellular fluid caused by increased permeability of vessels due to hypoxic process of the poisoning. While this diffuse subcortical edema was subsiding gradually in about 2 weeks, progressive brain atrophy was supervening and resulted finally in severe dilatation of the ventricular system. In spite of two exceptional cases of vegetative state with normal CT scan in early stage seemed suggestive of poor prognosis in most of cases. Pathogenesis of subcortical brain edema and the effect of hyperbaric therapy in the cases of acute carbon monoxide poisoning were also discussed.