DOI: https://doi.org/10.36347/sjmcr.2025.v13i10.095

Pages: 2586-2588

Introduction: Carbon monoxide (CO) poisoning represents a frequent medical emergency causing tissue hypoxia through its high affinity for hemoglobin. Clinical manifestations are often polymorphic and nonspecific, ranging from headaches and cognitive disorders to seizures, coma, and death, with risk of delayed neuropsychiatric sequelae. Case Report: We present the case of a 36-year-old patient with no significant medical history, admitted for acute accidental CO poisoning following prolonged exposure (over four hours) to fumes from a charcoal heater. The initial cerebral CT scan revealed symmetric nodular hypodensities in both globi pallidi, while biological parameters and chest X-ray were normal. Discussion: Radiologically, cerebral CT scan, often used as first-line imaging, may be normal or show diffuse edema and white matter hypodensities. Although less sensitive than MRI, it remains crucial in emergency settings for diagnostic orientation and severity assessment alongside clinical data. MRI, more sensitive, typically demonstrates characteristic lesions of the globi pallidi and white matter involvement, allowing better prognostic evaluation and follow-up. The topographic progression of lesions typically begins in the globi pallidi before extending to other basal ganglia structures. Pathophysiologically, the selective vulnerability of basal ganglia relates to their high energy metabolism and rich vascularization, making them particularly sensitive to hypoxic injury. Conclusion: This case illustrates the diagnostic value of cerebral imaging in CO poisoning. CT scanning maintains its role in initial assessment due to its accessibility, while MRI remains the gold standard for precise lesion characterization, prognostic evaluation, and follow-up of patients with CO intoxication.