COMPUTED-TOMOGRAPHY OF THE BRAIN IN ACUTE CARBON-MONOXIDE POISONING

Of 107 patients admitted to the South Western Hyperbaric Medical Centr e with acute carbon monoxide poisoning for hyperbaric oxygen therapy 1 9 bad cerebral imaging performed: 17 patients had CT, one patient had MRI and CT and one patient MRI alone. The role of brain CT is establis hed in determining the prognosis from acute carbon monoxide poisoning, Brain imaging was indicated because of unconsciousness on admission a nd failure or delayed improvement in neurological status after initiat ion of hyperbaric oxygen therapy. Of the 18 patients who underwent bra in CT, seven were found to have the characteristic changes of bilatera l low attenuation areas within the globus pallidus and six had low att enuation changes within cerebral white matter. In two patients there w ere both globus pallidus and cerebral white matter changes. Out of the total of the 19 patients who mere studied, four patients died, 10 rec overed fully and five had variable disabilities ranging from short ter m memory loss to more severe cognitive impairment and physical disabil ity. The role of CT and the practicalities of hyperbaric oxygen therap y for acute carbon monoxide poisoning are discussed in the light of th e experience from a regional dedicated medical diving centre.