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Abstract
Context: This study assessed the results of diffusion-weighted imaging (DWI) at presentation for acute charcoal-burning carbon monoxide (CO) poisoning and investigated whether the initial DWI results can predict long-term neurologic outcomes.
Methods: The study included 128 patients who suffered from CO poisoning after burning charcoal and underwent DWI. These patients were divided into two groups based on imaging results: a normal DWI group and an abnormal DWI group. Data regarding clinical courses and long-term neurologic outcomes (persistent severe neurologic sequelae) were collected and compared.
Results: The rate of abnormal DWI findings at presentation was 23.4%, and the most common site of abnormalities was the globus pallidus. All lesions in abnormal DWI had decreased apparent diffusion coefficient (ADC) values. The long-term neurologic state was assessed at a median follow-up of 19.5 months, and the frequency of poor long-term neurologic outcome was significantly higher in the abnormal DWI group (40.0% in the abnormal DWI group vs. 1.0% in the normal DWI group; p < .001). Abnormal DWI (odds ratio [OR]): 31.3, 95% confidence interval [CI]: 2.5–397) and old age (OR 1.1, 95% CI: 1.001–1.13) were independent factors for poor long-term neurologic outcomes, whereas the Glasgow Coma Scale score at presentation (OR: 0.7, 95% CI: 0.6–0.9) was negatively associated with the risk of poor long-term neurologic outcome.
Conclusions: In cases involving CO poisoning due to charcoal burning, DWI at presentation may help predict the long-term neurological outcome after discharge.
Disclosure statement
No potential conflict of interest was reported by the authors.