EC Clinical and Medical Case Reports

Carbon monoxide (CO) exposure is a common cause of toxic brain damage, ranging from transient neurological dysfunction to coma and death. Consequently, hypoxic brain damage is most notable in regions like the globus pallidus, basal ganglia, cerebral white matter, and the cerebral cortex. Diagnosis necessitates a heightened level of suspicion, alongside clinical assessment, analysis of patient carboxyhemoglobin (COHb) levels. Additionally, cardiology evaluation and neurological assessment, encompassing brain imaging especially Brain MRI, are essential components of the diagnostic process. This article reports a case of a young patient exposed to CO because of an apartment house's faulty gas heater. The MRI revealed cerebral lesions characterized as extensive and isolated laminar cortical necrosis (LCN), affecting both cerebral hemispheres.

 Keywords: Carbon Monoxide; Brain Toxicity; Laminar Cortical Necrosis; Magnetic Resonance Imaging

1. Ennafaa I., et al. “Nécrose laminaire corticale compliquant un état de mal épileptique”. Medecine Therapeutique3 (2018): 218-220.
2. Bleecker ML. “Carbon monoxide intoxication”. In: Handbook of Clinical Neurology. Elsevier B.V (2015): 191-203.
3. Prockop LD and Chichkova RI. “Carbon monoxide intoxication: An updated review”. Journal of the Neurological Sciences1-2 (2007): 122-130.
4. Gobert D., et al. “Nécrose laminaire corticale”. Revue Neurologique12-1 (2008).
5. Finsterer J. “Laminar cortical necrosis in mitochondrial disorders”. Clinical Neurology and Neurosurgery 111 (2009): 655-658.
6. Khardenavis V., et al. “Cortical laminar necrosis in a case of migrainous cerebral infarction”. BMJ Case Report (2018).
7. Yoneda Y and Yamamoto S. “Cerebral cortical laminar necrosis on diffusion-weighted MRI in hypoglycaemic encephalopathy”. Diabetic Medicine8 (2005): 1098-1100.
8. Liu X., et al. “Cortical laminar necrosis following the rapid correction of drug-induced hyponatremia”. Neurological Sciences 36 (2015): 1725-1727.
9. Karaarslan E and Arslan A. “Diffusion weighted MR imaging in non-infarct lesions of the brain”. European Journal of Radiology 65 (2008): 402-416.
10. Valanne l., et al. “Laminar Cortical Necrosis in MELAS Syndrome: MR and Neuropathological Observations”. Neuropediatrics3 (1996): 154-160.