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Aim:The aim of this study is to analyze children with acute carbon monoxide (CO) poisoning and to present two patients with rare neuroradiological findings.Materials and Methods:We identified and reviewed the medical records of pediatric patients diagnosed with acute CO intoxication who were hospitalized in our department during a 10-year period. Epidemiologic and clinical data were collected and analyzed.Results:A total of 326 children (166 girls, 160 boys; age range 1 to 17.8 years) with CO poisoning were identified. Their ages ranged from 1 to 17.8 years, with a mean of 8.3±4.8 years. Improperly vented coal or wood stoves were the most common (80.7%) cause of intoxication. The most common presenting symptoms were nausea/vomiting and headache. Seizure was seen in 32 patients (9.8%). Two patients died and the mortality was 0.6%. All patients received normobaric oxygen therapy until their carboxyhemoglobin (COHb) levels were decreased below 2% and their symptoms resolved. One hundred of the 326 patients (30.7%) also were treated with hyperbaric oxygen (HBO) therapy as indicated by the signs and symptoms or COHb levels. Brain imaging was performed in 19 patients (thirteen magnetic resonance imaging and six computerized tomography), and was normal in 15. Acute brain stem demyelination related to water pipe smoking developed in one patient. All patients showed complete recovery without neurological sequelae except one who had mild right hemiparesis at discharge.Conclusion:Acute CO intoxication is an important health problem in our country, especially in winter, because of poorly functioning heating systems. The clinical spectrum including neurological findings varies during childhood. We suggest that HBO therapy could be used safely in children. We believe that the combined administration of pulse methylprednisolone and HBO treatment might reduce cerebral damage caused by CO poisoning in selected pediatric patients.

Coronavirus disease (COVID-19) caused by a new coronavirus, SARS-CoV-2, has become a serious health problem throughout the world. Although COVID-19 primarily presents as an acute respiratory tract infection, many neurological findings have also been described in patients. Neurological findings are classified into three groups as central, peripheral nervous system and musculoskeletal system. The most common central nervous system symptom is headache. Encephalitis, encephalopathy, seizures, acute ischemic stroke are also seen. The most common symptoms in the peripheral nervous system are loss of smell and taste. Myalgia, myositis and rhabdomyolysis also can be seen in musculoskeletal system involvement. Awareness of the neurological symptoms by physicians will be beneficial in early diagnosis and treatment of the disease. [ABSTRACT FROM AUTHOR]

Miyeloroliferatif neoplaziler (MPN) pluripotent kök hücre düzeyinde genetik bozukluklardan kaynaklanan, her biri kendine özgü fenotipik, genetik ve klinik özellikleri olan klonal kök hücre hastalıklarıdır. MPN"li olgularda ortaya çıkan semptom ve komplikasyonlarda özellikle nörolojik olaylarda yaş önemli bir faktördür.Kronik miyelositik lösemi olgularında beyaz küre sayısının çok fazla olmasına bağlı (lökostaz) santral sinir sistemi (SSS) bulgularına yol açabilir. İlk tanıda veya hastalığın seyri sırasında kemik iliği dışında yani ekstra medüller alanlarda ekstramedüller miyeloid tümörler (EMMT) olarak isimlendirilen ve lösemik hücrelerin oluşturduğu kitleler diğer doku ve organların yanı sıra gerek SSS"inde gerekse spinal korda bası etkisine yol açan kitleler nedeniyle nörolojik semptom ve bulgulara yol açar. Santral sinir sistemi tutulumu ve trombositopenik kanamalar nörolojik semptom ve bulgulara yol açabilir.Polisitemia verada geçici iskemik atak ve trombotik inme en sık bulgulardır. Tromboz ve hemoraji yanısıra akut lösemiye transfromasyon nörolojik bulgu ve belirtilere yol açabilir. Esansiyel trombositozda geçici iskemik atak, trombotik inme ve zellikle hemoraji diğer MPN"lerdekine benzer nörolojik semptomlara yol açabilir. Miyelofibroziste ekstramedüller hematopoez vücutta yaklaşık her organ/dokuda ortaya çıkan kemik iliği dışındaki kan yapımı odaklarıdır. EMH odakları intrakranyal bası yapan kitle ve spinal kord kompresyonuna, nöbetlere, hidrosefaliye yol açabilir. Nadir olmakla birlikte kranyal/spinal meninkslerde, paraspinal dokuda ve intraserebral lokalizasyonda EMH saptanabilir. Santral ve periferik sinirlerde, koroid pleksusta, pituiter bezde, orbitada, orbital ve lakrimal fossada, sfenoid sinusta EMH rapor edilmiştir.

Myeloproliferative neoplasms (MPN) arise from genetic deficiencies at the level of pluripotent stem cells. Each of these neoplasms is a clonal stem cell disorder with specific phenotypic, genetic and clinical properties. Age is one of the most important factors in the development of symptoms and complications associated with MPNs.High white blood cell counts in chronic myelocytic leukemia also known as leukocytosis may lead to central nervous system findings. Tumors developing outside the bone marrow named as extramedullary myeloid tumors (EMMT) could be detected at the initial diagnosis or during the prognosis of the disease, which may cause neurological symptoms due to pressure of leukemic cell mass on various tissues along with spinal cord. Central nervous system involvement and thrombocytopenic hemorrhage may lead to diverse neurological symptoms and findings.Transient ischemic attack and thrombotic stroke are the most common symptoms in polycythemia vera. Besides thrombosis and hemorrage, transformation to acute leukemia can cause neurological symptoms and findings. Transient ischemic attack, thrombotic stroke and specifically hemorrage can give rise to neurological symptoms similar to MPN in essential thrombocytosis.Extramedullary hematopoiesis refers to hematopoietic centers arise in organ/tissues other than bone marrow in myelofibrosis. Extramedullar hematopoietic centers may cause intracranial involvement, spinal cord compression, seizures and hydrocephalia. Though rare, extramedullary hematopoiesis can be detected in cranial/spinal meninges, paraspinal tissue and intracerebral regions. Extramedullary hematopoiesis has been reported in peripheral neurons, choroid plexus, pituitary, orbits, orbital and lacrimal fossa and in sphenoidal sinuses. [Cukurova Med J 2013; 38(2.000): 157-169]