Cases of Wallerian degeneration of bilateral cerebral peduncles after acute carbon monoxide poisoning have not yet been reported. To date, most of the delayed encephalopathy after acute carbon monoxide poisoning (DEACMP) lesions captured in magnetic resonance imaging (MRI) has been located in the subcortical white matter and basal ganglia. Here we report two cases of DEACMP with abnormalities in the bilateral cerebral peduncles. The etiology of abnormalities, which were strictly confined to the bilateral cerebral peduncles, was Wallerian degeneration secondary to upstream nerve axonal damage, making this the first report on such bilateral cerebral peduncle abnormalities after DEACMP. In this report, we present two cases of DEACMP with abnormal signals in the bilateral cerebral peduncles captured during brain MRIs. Case 1 was of a 68-year-old man who presented with paroxysmal disturbance of the consciousness, left limb weakness for 16 days, and lagging responses for 2 days. Case 2 was of a 55-year-old man who was unconscious for 6 h. In addition to the above mentioned characteristics on the brain MRIs, the electroencephalography of case 1 indicated that his forehead scans had a mixture of wide sharp, sharp, and three-phase waves. Brain diffusion tensor imaging of case 2 further proved that the bilateral cerebral anomalies represented Wallerian degeneration secondary to upstream axonal damage. After the definitive diagnosis, the patients returned to the local hospital for hyperbaric oxygen therapy. Wallerian degeneration of the bilateral cerebral peduncles after acute carbon monoxide poisoning has never been reported before. The abnormal signals in the bilateral cerebral peduncles captured during brain MRIs indicated Wallerian degeneration secondary to upstream axonal damage; thus, these two cases may further our understanding of DEACMP imaging.

中文翻译：

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急性一氧化碳中毒后双侧脑梗的沃勒变性。

急性一氧化碳中毒后双侧脑梗的沃勒氏变性病例尚无报道。迄今为止，在磁共振成像（MRI）中捕获的急性一氧化碳中毒（DEACMP）病变后，大多数迟发性脑病都位于皮层下白质和基底神经节中。在这里，我们报告了两例双侧脑柄畸形的DEACMP病例。异常的病因严格限于双侧脑梗，是继上游神经轴突损伤后继发的沃勒变性，这是继DEACMP之后关于这种双侧脑梗异常的首次报道。在本报告中，我们介绍了两例在大脑MRI期间捕获到的双侧脑柄有异常信号的DEACMP病例。病例1是一个68岁的男子，他出现了发作性的意识障碍，左肢无力16天，反应滞后2天。案例2是一个55岁的男性，昏迷了6小时。除了脑部MRI的上述特征外，病例1的脑电图显示他的额头扫描混合了宽尖锐波，尖锐波和三相波。病例2的脑扩散张量成像进一步证明，双侧脑部异常代表上游轴突损伤继发的Wallerian变性。明确诊断后，患者返回当地医院进行高压氧治疗。以前从未报道过急性一氧化碳中毒后双侧脑梗的沃勒变性。在脑部MRI期间捕获到的双侧脑柄异常信号表明，沃勒氏变性继发于上游轴突损伤。因此，这两种情况可以进一步加深我们对DEACMP成像的理解。