TAILIEUCHUNG - Ebook Neuroradiology - Expect the unexpected: Part 2

Part 2 book “Neuroradiology - Expect the unexpected” has contents: Carbon monoxide poisoning sequelae, infiltrative brainstem lymphoma, crouzon syndrome, primary intraosseous haemangioma of the skull base, sphenoid wing meningocele, intraorbital aspergilloma, and other contents. | Carbon Monoxide Poisoning Sequelae Two days before being admitted to our university hospital, a young lady (28) was urgently hospitalised at a regional hospital after she had been found unresponsive on the bathroom floor. Carbon monoxide poisoning caused by malfunctioning gas-powered water boiler was suspected. The initial CT exam was reported as normal. Upon waking from coma, she had left-sided hemiparesis. During the next several days, her neurological status became completely normal, but ventricular extrasystolia was noticed, so a suspicion of cardiogenic loss of consciousness arose. A MRI exam of the brain was requested (Fig. ). The imaging findings were compatible with carbon monoxide poisoning, but not very dramatic since the MRI exam was done 6 days after carbon monoxide inhalation and the patient recovered completely. An example of CT and MRI findings in the setting of acute carbon monoxide poisoning (in a different patient) is shown in Fig. : Carbon Monoxide Poisoning Carbon monoxide (CO) is a colourless, odourless, tasteless, non-irritant gas produced by incomplete combustion of carbon-based fuels and substances. It is produced by common household appliances, heating equipment and internal combustion engine motors. 11 Carbon monoxide poisoning is the most frequent cause of accidental poisoning and can be fatal; it is frequently unrecognised due to its non-­specific clinical presentation, unless typical history of CO exposure is provided. The patient is often unresponsive; the clinical findings are highly variable and non-specific. The symptoms may vary from headache, nausea and vomiting to confusion, ataxia, seizures, coma, myocardial infarction and death. Long-term low-level CO exposure may be the cause of chronic fatigue, memory deficits, vertigo, neuropathy, diarrhoea and abdominal pain. There may be a delayed encephalopathy of carbon monoxide intoxication, characterised by a recurrence of neurological or psychiatric symptoms [1]. The

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• Intraorbital Aspergilloma
• Carbon monoxide poisoning sequelae
• Infiltrative brainstem lymphoma
• Crouzon syndrome
• Primary intraosseous haemangioma
• Occipital bone intradiploic encephalocele