Carbon monoxide induced delayed post-hypoxic leukoencephalopathy in a morphine addict: a case report


  • Humaira Achakzai Assistant Professor Department of Medicine Rehman Medical institute, Peshawar
  • Ihtesham Shafiq Trainee Medical Officer Internal Medicine Rehman Medical Institute Peshawar
  • Eemaz Nathaniel Final Year MBBS Rehman Medical College Peshawar


A 54-year-old male, marijuana smoker was found unconscious in his home because of a gas leak and gastric lavage was done, with aspirate of morphine in his stomach, after that he was hydrated. The case was then presented to us in January 2019 and non- contrast CT was done which showed multiple hypo-dense areas in white matter and basal ganglia, which was first thought to be secondary to CO poisoning and morphine. We discharged the patient. After a few days, he developed headache with associated nausea, and we gave supportive treatment. He remained cognitively healthy till he began to experience loss of consciousness with the development of aspiration pneumonia afterward. He was on mechanical ventilation. The MRI showed T2 hyperintensities in periventricular and subcortical regions, indicative of delayed post-hypoxic leukoencephalopathy, consistent with neuropsychiatric sequelae of anoxic injury because of CO poisoning.

Keywords: Morphine; Carbon Monoxide Poisoning; Unconsciousness; Leukoencephalopathy.