Abstract
Ethylene glycol (EG), commonly found in antifreeze and deicing solutions, continues
to be a cause of morbidity and mortality in the pediatric population. EG metabolism
produces toxins that cause metabolic acidosis and calcium oxalate deposition throughout
the body. Deposition in the central nervous system is associated with significant
neurologic sequelae, including altered mental status, seizures, and cerebral edema.
We present a case of intentional EG poisoning in a 17-year-old male with resulting
cerebral edema and coma. Neuroimaging studies were initially normal but eventually
demonstrated diffuse abnormalities on both cranial computed tomography and magnetic
resonance imaging (MRI). The patient ultimately made a complete recovery with resolution
of the MRI abnormalities noted at the peak of illness. While neuroimaging is often
incorporated into the management of EG poisoning, this is the first case report to
show the evolution of EG-related MRI changes before, during, and after the resolution
of EG-induced intracranial hypertension.
Keywords
ethylene glycol toxicity - magnetic resonance imaging - computed tomography - cerebral
edema
