ABSTRACT

Graffeo CS, Petitt MJ, Neubauer LE, Steckler GD, Knapp BJ. Reversal of a Globus Pallidus Injury in a Severe Carbon Monoxide Poisoned Patient. Undersea Hyperb Med. 2025 Fourth Quarter; 52(4):565- 569.

Carbon monoxide (CO) is an important source of poisoning in the United States and accounts for
over 50,000 emergency department (ED) visits annually. Of these, almost 15,000 cases are reported as intentional, with over 1,000 deaths annually reported in the USA.1 Unintentional deaths from carbon monoxide poisoning are commonly associated with the improper use of generators, heaters, or other sources of combustion, such as malfunctioning home appliances or vehicular exhaust [2,3].

We describe a case of severe intentional CO poisoning that had reversal of CT and MRI findings that were consistent with a globus pallidus injury and a favorable clinical outcome in an adult male treated with Hyperbaric Oxygen Therapy (HBO2). There are currently conflicting data and guideline recommendations regarding the utility of HBO2 in the management of CO.4 This case provides additional evidence for HBO2 treatment in a patient population whose clinical presentation and imaging findings are consistent with severe poisoning.

Keywords: carbon monoxide; case reports; clinical toxicology; globus pallidus; hyperbaric oxygen therapy; treatment