Carbon monoxide poisoning with an atypical presentation on MRI: Case report and literature review

INTRODUCTION: Acute carbon monoxide poisoning can present with altered mentation, loss of consciousness, and other symptoms. Accurate diagnosis is based on a detailed history, clinical examination, and laboratory evidence. MRI is also crucial in detecting hypoxic-ischemic encephalopathy due to CO poisoning and has established superiority over CT scans. We report an atypical MR imaging pattern seen in a patient post-CO exposure. CASE PRESENTATION: We report a case of a 35-year-old South Asian man who presented to the emergency department with loss of consciousness for an undetermined time. GCS on arrival was 4/15. Detailed history, physical examination, and radiological investigations confirmed the diagnosis of carbon monoxide poisoning. He was treated with 100% oxygen. CONCLUSION: MRI should be included as a diagnostic workup for suspected CO poisoning patients to evaluate hypoxic-ischemic encephalopathy. This will not only aid in the correct diagnosis but will also help in guiding the correct management of the patients.