Advertisement

AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Hydrogen Peroxide Toxicity

  • Ingestion of high concentrations of hydrogen peroxide (H2O2) can result in cerebral air embolism.
  • Onset of symptoms and imaging abnormalities does not develop at the time of ingestion; rather, gas formation and subsequent embolism may take several days.
  • Hydrogen peroxide decomposes via an exothermal reaction into water and oxygen. Oxygen gas bubbles generated after H2O2 ingestion diffuse into the venous circulation and pass directly into the arterial circulation via a patent foramen ovale, pulmonary arteriovenous fistula, or transpulmonary transportation over the pulmonary capillary bed.
  • Key Diagnostic Features: MR diffusion and FLAIR images demonstrate multiple foci of cerebral ischemia, predominately in a cortical distribution. Air emboli can be directly visualized on Doppler ultrasound or CT scan.
  • DDx: Embolism from any source, including valvular, cardiac, or vascular etiology
  • Rx: Early hyperbaric oxygen therapy can result in complete neurologic recovery.
December 16, 2013
A 48-year-old man with history of hepatitis C and intravenous drug use presenting with acute onset upper and lower extremity weakness (left greater than right) and left-sided paresthesias after accidental ingestion of ΒΌ cup of 12% hydrogen peroxide
View Case
Advertisement
Subscribe to RSS - Hydrogen Peroxide Toxicity