American Board of Psychiatry and Neurology (ABPN) Practice Exam

The lesions associated with coma from carbon monoxide poisoning are primarily found in the globus pallidus due to its susceptibility to hypoxic injury. Carbon monoxide binds to hemoglobin more effectively than oxygen, leading to a state of hypoxia and subsequent neuronal cell death, especially in areas of the brain that are highly vulnerable to low oxygen levels.

The globus pallidus is critically involved in the regulation of voluntary movement and is part of the basal ganglia. It is particularly affected because it has a high metabolic demand and low oxygen reserve. Consequently, during episodes of carbon monoxide poisoning, regions like the globus pallidus demonstrate the most significant damage when examined histologically, which correlates with the clinical presentation of coma and other neurological deficits.

While other regions such as the cingulate gyrus, corona radiata, and thalamus may also sustain injury due to hypoxia, the globus pallidus is specifically noted for its pronounced lesions in the context of carbon monoxide exposure, making it the most relevant area to consider in this situation.