Could your acute stroke patient be carbon monoxide poisoning?


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Taşkın Ö., Dişel N. R.

ACTA NEUROLOGICA BELGICA, vol.123, no.4, pp.1569-1570, 2023 (SCI-Expanded)

  • Publication Type: Article / Editorial Material
  • Volume: 123 Issue: 4
  • Publication Date: 2023
  • Doi Number: 10.1007/s13760-022-02038-4
  • Journal Name: ACTA NEUROLOGICA BELGICA
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED)
  • Page Numbers: pp.1569-1570
  • Çukurova University Affiliated: Yes

Abstract

Carbon monoxide (CO) is a colorless, odorless, tasteless and non-irritating gas and its exposure causes 50,000 Emergency Department (ED) admissions and 1300 deaths in the United States (US) every year. Carbon monoxide binds to the heme with approximately 240 times the affinity of oxygen and this raises the level of carboxyhemoglobin (COHb). Nonsmokers may have up to 3% COHb levels while smokers may have levels of 10–15% [1].

The clinical findings of carbon monoxide poisoning (COP) are variable and nonspecific. Mild and moderate cases present with symptoms including headache, nausea, and dizziness. However, syncope, shortness of breath, loss of consciousness, chest pain, could be the symptoms of serious poisoning which might cause pulmonary edema, myocardial ischemia, ventricular arrhythmias and coma because of its effects on the heart and brain.

Patients diagnosed with COP and recovered from suffer- ing long-term neurocognitive sequelae due to brain damage. Delayed neuropsychiatric syndrome is seen in almost 40% of patients with serious poisoning [1]. Hemiplegia and dys- arthria are the symptoms of acute stroke patients in general and are very rare to be seen in COP patients. In this case report, we present a patient who presented to the ED with hemiplegia and dysartia and who was further diagnosed with COP.