Delayed Neurological Sequelae Successfully Treated with Adjuvant, Prolonged Hyperbaric Oxygen Therapy: Review and Case Report

Luca Martani, Andrea Giovanniello, Gerardo Bosco, Luca Cantadori, Francesca Calissi, Dany Furfaro, Massimo Pedrazzini, Rosanna Vaschetto, Enrico Mario Camporesi and Matteo Paganini
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Luca Martani: Vaio Hospital, 43036 Fidenza, Italy
Andrea Giovanniello: Casa di Cura HABILITA I Cedri, 28073 Fara Novarese, Italy
Gerardo Bosco: Department of Biomedical Sciences, University of Padova, 35131 Padova, Italy
Luca Cantadori: Vaio Hospital, 43036 Fidenza, Italy
Francesca Calissi: Rivoli Hospital, 10098 Rivoli, Italy
Dany Furfaro: Ospedale Parini, 11100 Aosta, Italy
Massimo Pedrazzini: Vaio Hospital, 43036 Fidenza, Italy
Rosanna Vaschetto: Department of Translational Sciences, University of Eastern Piedmont, 28100 Novara, Italy
Enrico Mario Camporesi: Department of Surgery, University of South Florida, Tampa, FL 33606, USA
Matteo Paganini: Department of Biomedical Sciences, University of Padova, 35131 Padova, Italy

IJERPH, 2022, vol. 19, issue 9, 1-9

Abstract: Carbon Monoxide (CO) intoxication is still a leading cause of mortality and morbidity in many countries. Due to the problematic detection in the environment and subtle symptoms, CO intoxication usually goes unrecognized, and both normobaric and hyperbaric oxygen (HBO) treatments are frequently administered with delay. Current knowledge is mainly focused on acute intoxication, while Delayed Neurological Sequelae (DNS) are neglected, especially their treatment. This work details the cases of two patients presenting a few weeks after CO intoxication with severe neurological impairment and a characteristic diffused demyelination at the brain magnetic resonance imaging, posing the diagnosis of DNS. After prolonged treatment with hyperbaric oxygen, combined with intravenous corticosteroids and rehabilitation, the clinical and radiological features of DNS disappeared, and the patients’ neurological status returned to normal. Such rare cases should reinforce a thorough clinical follow-up for CO intoxication victims and promote high-quality studies.

Keywords: carbon monoxide; hyperbaric oxygen; hyperbaric oxygen therapy; delayed neurologic sequelae; intoxication; poisoning (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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