To the Editor.—
In the August 1978 issue of the Archives (35:517-521), De Reuck and Vander Eecken characterized focal subcortical lesions resulting from severe hypoxic cerebral insults. We would like to describe an unusual case of cerebral hypoxia and add comments on the pathogenesis of focal brain lesions.A 45-year-old man was accidentally exposed to high-pressure hydrogen sulfide (H2S) gas and was immediately rendered unconscious. Respiratory assistance was instituted, and spontaneous respiration soon resumed. However, the victim remained comatose, exhibiting increased tonus with extensor spasms and Babinski's signs. Computerized tomography (CT) of the head revealed bilateral symmetrical lucent lesions within the cerebral hemispheres. He remained in a chronic vegetative state and died approximately five weeks after exposure to the gas. An autopsy was not permitted.Superimposition of a corresponding normal brain slice on the CT scan image strongly suggested that the lucent lesions represented necrotic areas involving the
Matsuo F, Cummins JW, Anderson RE. Neurological Sequelae of Massive Hydrogen Sulfide Inhalation. Arch Neurol. 1979;36(7):451–452. doi:10.1001/archneur.1979.00500430081019
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