CNS nontumor

Toxic and metabolic disorders

Carbon monoxide injury

Last author update: 1 February 2015
Last staff update: 20 June 2023 (update in progress)

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PubMed Search: Carbon monoxide [title] CNS

Kymberly A. Gyure, M.D.
Page views in 2022: 533
Page views in 2023 to date: 678
Cite this page: Gyure K.A. Carbon monoxide injury. website. Accessed October 2nd, 2023.
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

Contributed by Kymberly A. Gyure, M.D.

Carbon monoxide injury

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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