CEREBRAL METABOLIC CHANGES IN DELAYED CARBON-MONOXIDE SEQUELAE STUDIED BY PROTON MR SPECTROSCOPY

The pathogenesis of delayed sequelae of carbon monoxide (CO) exposure is still unknown. We repeatedly examined a 55-year-old woman with the interval form of CO poisoning, using proton magnetic resonance spectro scopy (MRS). When the clinical picture was severe, MRS revealed marked ly lowered N-acetyl-asparatate (NAA)/creatine and phosphocreatine (Cr) ratio and slightly increased choline containing compounds (Cho)/Cr ra tio. Subsequently, NAA and Cho/Cr ratio tended to return to normal, re flecting clinical improvement. Proton MRS shows the previously unrecog nised neuronal activity in CO poisoning and precisely reflects the sev erity of symptoms. We stress the superiority of proton MRS over the co nventional radiological examinations in CO poisoning.