CNS nontumor
Toxic and metabolic disorders
Carbon monoxide injury

Topic Completed: 1 February 2015

Revised: 31 December 2018, last major update February 2015

Copyright: (c) 2002-2017,, Inc.

PubMed Search: Carbon monoxide [title] CNS

Kymberly A. Gyure, M.D.
Page views in 2018: 443
Page views in 2019 to date: 254
Cite this page: Gyure K.A. Carbon monoxide injury. website. Accessed July 16th, 2019.
Definition / general
  • Affects globus pallidus and white matter
Pathophysiology / etiology
  • Carbon monoxide binds to hemoglobin, forming carboxyhemoglobin
  • This causes a decrease in the oxygen carrying capacity of the blood, leading to tissue hypoxia
  • Sources of exposure to carbon monoxide include faulty or inadequately ventilated heating sources and engine exhaust
  • Exposure is most commonly accidental or due to a suicide attempt
Clinical features
  • Acute: headache, myalgia, dizziness, psychological impairment
  • Chronic: delayed neuropsychiatric syndrome ranging from subtle personality changes or mild cognitive deficit to severe dementia, psychosis, parkinsonism
Diagnosis / laboratory
  • Measurement of carboxyhemoglobin levels
Radiology description
  • High signal intensity in globus pallidus bilaterally on T2 weighted MR images
  • Restricted diffusion in white matter (diffusion weighted imaging [DWI], a form of MR imaging)
Radiology images

Images hosted on other servers:

16 hours after injury

Case reports
  • Administration of hyperbaric oxygen
Gross description
Gross images

Images hosted on other servers:

Contributed by Dr. Kymberly Gyure

Microscopic (histologic) description
  • Foci of ischemic or hemorrhagic necrosis in globus pallidus (Wikipedia: Globus Pallidus)
  • Perivascular foci of demyelination in deep white matter with sparing of arcuate fibers
Differential diagnosis
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