• Med Princ Pract · Jan 2009

    Case Reports

    Carbon monoxide-induced cortical visual loss: treatment with hyperbaric oxygen four years later.

    • Mehmet G Senol, Senol Yildiz, Dilaver Ersanli, Gunalp Uzun, Tuna Gumus, Yavuz Narin, Sezai Ozkan, and Ali Ayata.
    • Department of Neurology, Gulhane Military Medical Academy, Haydarpasa Teaching Hospital, Istanbul, Turkey.
    • Med Princ Pract. 2009 Jan 1; 18 (1): 67-9.

    ObjectiveWe present a patient who developed visual loss after carbon monoxide (CO) poisoning and was treated with hyperbaric oxygen.Clinical Presentation And InterventionA 21-year-old woman poisoned with CO (with coma lasting 4 h and carboxyhemoglobin level 46%) developed seizures and cortical blindness 3 days after poisoning. Four years later, her visual acuity was 0.2 in both eyes. An (18)F-fluorodeoxyglucose positron emission tomography (PET) scan showed reduced metabolism in the bilateral posterior temporal and occipital lobes. The patient received a total of 50 hyperbaric oxygen sessions over 3 months for visual loss and the visual acuity improved to 0.5 in both eyes. In addition, increased metabolism was detected in the brain in post-treatment PET scans.ConclusionPET documented brain hypoperfusion 4 years after CO poisoning and hyperbaric oxygen therapy improved visual acuity. However, we cannot endorse routine use of hyperbaric oxygen for such patients, until results of further clinical trials demonstrate efficacy of hyperbaric oxygen in CO-induced chronic brain injury.Copyright 2008 S. Karger AG, Basel.

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