Fig. 26.

Presumed carbon monoxide poisoning. A 49-year-old man was found comatose and with an alcohol intoxication in his garage next to his car, which was not running. The patient received an MRI 14 days after admittance to the hospital. Coronal T2-weighted (a,c) and FLAIR images (c) showed T2-hyperintense lesions with central iso- to hypo-intense areas in both pallidi (white arrows) as well as T2 hyper-intensity of both hippocampi from head to tail involving the CA2 sector on the right and the CA1 and CA2 sectors on the left (white arrowheads). On follow-up MRI performed 4 months later, these abnormalities had disappeared (d). The patient suffered from amnesia and the details of what happened exactly remain a mystery to this date. The patient was suicidal and the abnormalities in the pallidi are very suggestive for carbon monoxide poisoning, however, with the hippocampal abnormalities reflecting damage to the especially vulnerable Sommers CA2 sector of the hippocampi