PMC9389144_01
The liquid sealant (nitrile type) inhaled by the patient.
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F1
Fluid-attenuated inversion recovery (FLAIR) and diffusion-weighted imaging (DWI) showed a high signal intensity and involvement of the bilateral parietal lobes, thus suggesting toxic encephalopathy (Supplementary Figure 1). He then started buying the liquid sealant online and inhaling it at home (Figure 1).
Brain magnetic resonance image obtained on the 3rd day after admission. Strip-like long T1 and T2 signal shadows in the subcortical white matter of both cerebral hemispheres are evident. There is a high intensity on both T2-fluid-attenuated inversion recovery and diffusion-weighted imaging. A fuzzy demarcation is visible between the skin and medulla. The septum pellucidum is widened and the midline structures are centered.
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F2
T2 MRI showed long strip-like signal shadows in the subcortical white matter of both cerebral hemispheres, with hyperintensity on T2-FLAIR and hyperintensity on DWI (Figure 2). The demarcation between the cortex and medulla was blurred. The septum pellucidum was widened and the midline structures were centered. MRI showed symmetrical and lace-like long T1 signals and long T2 signals in the dentate nucleus, basal ganglia, and white matter of the cerebellum (Supplementary Figure 2).
(A-D) Electroencephalogram obtained on the 6th day after admission. A high degree of abnormality and a poor background are evident. Low and medium amplitude activity theta dominates, while the medium amplitude delta rhythm is intermittent.
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F3
On the 6th day after admission, the electroencephalogram showed a high degree of abnormality (poor background, low and medium amplitude theta activity, and intermittent medium delta rhythm; Figure 3). The electroencephalogram obtained on the 14th day after discharge showed mild abnormalities, slow background activity, as well as diffuse, slightly low, and medium amplitude theta activity (Supplementary Figure 3).