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Extra resources for Carbon Monoxide Poisoning [Prog. in Brain Research Vol 24]

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CNS C H E . 12 male 26 years Table continued Clinical course and complications Case no. 4 male 63 years No improvement CRO . . 9 female 84years Improvement in 24 h then right hemiplegia BRO . 10 male 77 years Improvement,then aggravation DAS. 11 male 78 years Precocious improvement Tracheotomy + ++ W ++ + Collapse Pulmonary embolus Phlebitis 6th day Hyperthermia, renal insufficiency +++ 0 6th day Hyperthermia, bronchial obstruction +++ 0 8th day Hyperthermia, collapse, digestivehemorrhage 0 C *I Table continued % 2 $ g + + 4- 0 10 th day Hyperthermia, obstruction +++ 0 9th day Respiratory obstruction ++ Collapse 13 th day Hyperthermia, collapse C H E .

F A R D E A U Fig. 3. Case no. 3. Magnification x 400 - Wolcke’s stain. Frontal cortex: impregnation by ferric solution of shrivelled neurones at the edge of a necrotic zone. Case no. 4. SCH . . - e 1191 Male, 63 years. Intoxication with carbon monoxide of unknown duration; deep coma; cardiovascular signs (myocardial ischemia on ECG) ; tracheopulmonary obstruction requiring tracheotomy ; death 4 days after intoxication. Macroscopic examination :leptomeningesthin and transparent ;no atherosclerosisof the basal vessels, no temporal lobe herniation; on vertical transverse section of the hemispheres, global dilatation of the ventricular apparatus ;abnormal venous dilatation of the white matter; recent necrotic focus in both globi pallidi extending into the internal capsule.

Magnification x 17 - Wolcke’s stain. Corpus callosum: foci of hemorrhage (above) and scattered necrosis (below) along vascular routes. Microscopic examination : very limited necrosis in the superior portion of both globi pallidi at the point of contact with the internal capsule, bordered by a spongy hemorrhagic zone with large deposits of pseudo-calcium ; limited pallor of centrum ovale in myelin stains, increased by poor fixation; no anomalies in the cerebral cortex; Ammon’s horns could not be investigated; thalamus, striatum and mesencephalic structures intact; brain stem normal, aside from chromatolysis of the neurones in the dorsal lamina of the inferior olivary nuclei; partial lysis of the granular layer of the cerebellum and vascular dilatation in the axis of the cerebellar lamellae ; moderate cellular infiltration of the leptomeninges; marked vasostasis ; moderate diffuse arteriolosclerosis.

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