CT Diagnosis of Toxic Brain Injury in Cyanide Poisoning: Considerations

Two deaths occurred after ingestion of cyanide-containing Extra-Strength Excedrill capsules. Cranial CT scans obtained within 3 hr of each patient's collapse showed diffuse cerebral swelling and loss of gray-white differentiation. Most diffuse cerebral insults (hypoxia, ischemia) do not show such changes so soon after injury. The early onset of diffuse cerebral edema with loss of gray-white differentiation may be a clue to the diagnosis of acute cyanide poisoning.