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J Pediatr Intensive Care 2017; 06(03): 214-220
DOI: 10.1055/s-0037-1598206
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Reversibility of Severe Cerebral Magnetic Resonance Imaging Changes Associated with Ethylene Glycol Toxicity

Erin B. Owen
1   Division of Critical Care Medicine, Department of Pediatrics, University of Louisville, Louisville, Kentucky, United States
,
Aaron W. Calhoun
1   Division of Critical Care Medicine, Department of Pediatrics, University of Louisville, Louisville, Kentucky, United States
,
Mark J. McDonald
1   Division of Critical Care Medicine, Department of Pediatrics, University of Louisville, Louisville, Kentucky, United States
› Author Affiliations
Further Information

Publication History

17 October 2016

29 December 2016

Publication Date:
07 February 2017 (online)

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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
 

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