ABSTRACT

Carbon monoxide (CO) is a common environmental toxin and a leading cause of lethal poisoning around the world. Syste-mic and neurological changes related to CO intoxication oc-curs due to diffuse hypoxia and direct toxicity of the gas.

70 and 35 years old females, exposed accidentally to CO, 18 days and 8 months before death have analyzed.

Our first case was 70 year old female who had been expo-sed to CO at her house and found in a state of cardiopulmo-nary arrest. After admission, she was resuscitated and under-went artificial ventilation in a comatose state and died after 18 days.

Second case was 35 years old female with a history of CO intoxication, 8 months before. After 45 days of hospitalisation period, cooperation problems and movement disorders eventu-ally developed. She died due to injuries caused by falling from a height.

On macroscopic examination, first case had diffuse petechi-al bleeding on basal ganglia and bilateral necrosis of globus palli-dus. We found diffuse cortical atrophy and pale regions on basal ganglia, hyppocampus, cerebellum and cerebral white matter.

On microscopic examination, we found bilateral subacute infarction of globus pallidus, myelin degeneration and astrogli-osis in sentrum semiovale of first case. The second case had ne-uronal loss at cerebral cortex, hyppocampus, internal granular cell and purkinje cell layer of cerebellum, myelin pallor, white matter injury and astrogliosis around basal ganglia.

Grey and white matter lesions of both cases are common le-sions of CO intoxication. In the second case, particularly white matter lesions can explain neurologic sequeles. Neurologic or neuropsychological disorders can cause serious trauma on late phase of CO intoxication. However, although trauma alone is considered as the cause of death as seen as in second case, cont-ribution of neurophysiologic and neuropathologic changes due to CO intoxication on the process should not be ignored.

Keywords: Carbon monoxide, intoxication, brain, ne-uropsychiatric syndrome