発症後約2か月半が経過し，なお高圧酸素療法が著効した一酸化炭素中毒の1例

Hyperbaric Oxygen (HBO) Therapy Was Effective in A Case with CO Poisoning with An Interval of Two and A Half Months after the Accident

　【抄録】発症後約2か月半が経過した一酸化炭素中毒の42歳の女性に，1クール10回の高圧酸素療法（HBO）を2クール試み，HBO開始前，HBO 1クール終了時，2クール終了時の計3回，詳細な神経心理学的検査，頭部MRI，SPECTを用いて臨床経過を検討した結果，自発性の低下，注意集中力の低下の著明な改善がみられ，その時期に対応してSPECTにおいて前頭葉，側頭葉内側の血流改善が認められた。急性期，亜急性期を過ぎた一酸化炭素中毒においてもHBOが効果を示し，詳細な神経心理学的検査は客観的な臨床症状の評価に有用であった。また治療効果，症状改善の指標として脳機能画像が有用であった。

　A-42-year-old woman with carbon monoxide (CO) poisoning was evaluated by neuropsychological testing, brain magnetic resonance imaging (MRI), and single-photon emission computed tomography (SPECT) with ^99mTc-hexamethylpropyleneamine oxide (HMPAO) . At an interval of two and a half months after the accident, the patient showed loss of drive, attention, and concentration. The SPECT scans demonstrated cerebral hypoperfusion in the bilateral frontal and mediotemporal regions. After 20 administrations of hyperbaric oxygen (HBO), the patient recovered remarkably. Cerebral bloodflow increased in both the frontal and mediotemporal regions as clinical recovery progressed. HBO was effective in CO poisoning beyond the acute or subacute phase. Comprehensive neuropsychological testing combined with brain functional imaging seems useful to evaluate clinical improvement and effect of HBO in patients with CO poisoning.