The value of brain CT findings in acute methanol toxicity (original) (raw)

Role of Imaging in Acute Methanol Intoxication -A Case Series

Methanol is a clear, colorless, highly toxic volatile liquid with an odour and taste similar to ethanol. Acute methanol poisoning produces sever metabolic acidosis and serious neurological symptoms. CT (Computed Tomography) and MRI (Magnetic Resonance Imaging) are able to demonstrate toxic effects of methanol intoxication in the CNS (Central Nervous System) including putaminal necrosis with or without hemorrhage and pathologies involving subcortical white matter, hippocampus, optic nerve, tegmentum, cerebral gray matter and cerebellum. Here we present three cases demonstrating different CNS changes demonstrated in MRI.

Cerebral Methanol Intoxication: A Case Report with Literature Review

Canadian Institute for Knowledge Development (CIKD), 2021

We report the case of a 24-year-old man admitted to the emergency room with a history of headache exacerbated. At the emergency room, he was unresponsive to drug or alcohol consumption. At this time, computed tomography (CT) did not detect the brain and abdomen lesions. At the intensive care unit (ICU), 6h later, he suddenly developed shallow respirations, followed by loss of consciousness, hypotension, and blurred vision. He was intubated immediately and underwent mechanical ventilation. Arterial blood gases and biochemical analyses indicated intense metabolic acidosis (Day1: pH 7.25, PCO2 49 mmHg, PO2 65 mmHg, HCO3 15 mmol/L and day 2, pH 7.32, PCO2 45 mmHg, PO2 60 mmHg, and HCO3=19 mmol/L) and elevated liver enzymes. The clinical diagnosis of toxic alcohol ingestion was based on the history, arterial blood gases results, and significant biochemical changes. In ICU, the patient underwent ethanol infusion and hemodialysis and the impression of methanol intoxication. He underwent redialysis with a minimal dose of heparin (5000 IU/mL). A second CT scan revealed basal ganglia ischemia, and an MRI scan exhibited clear abrasion and basal ganglia necrosis. Finally, he died due to severe methanol intoxication, but the probability of cerebral hemorrhage may be the cause of the patient death associated with heparin

Two cases of methanol poisoning: CT and MRI features

Australasian Radiology, 2007

Methanol poisoning in Australia is now very rare as methanol has been removed from methylated spirits. In acute intoxication methanol may result in a wide range of damage to the central nervous system. Few cases have been imaged with MRI. We present two cases and their striking neuroimaging findings with a discussion of the published work on methanol poisoning. computed tomography; magnetic resonance imaging; methanol; poisoning; putamen. CASE REPORT Two male sailors aged 43 and 44 years were imaged in our department following their consumption of a quantity of liquid containing 58% methanol, which they mistakenly believed to be ethanol. Both sailors were inebriated when they arrived in the emergency department. Neither had any significant medical history. Patient 1 This patient presented with nausea, vomiting and impaired vision. He complained of general darkening of his vision with black spots in his visual field. His clinical state rapidly deteriorated into a coma and he had a generalized seizure before being intubated. Initial biochemistry showed profound acidosis with a pH of 6.82 and lactate of 7.4 mmol/L. Blood ethanol was undetectable, but 0.17 g/L of methanol was detected producing an increased anion gap. Emergency treatment consisted of oral and i.v. ethanol to compete with the metabolism of methanol. I.v. bicarbonate was also given. In the intensive care unit (ICU), haemodialysis followed by continuous veno-venous haemodialysis was undertaken. These interventions resulted in the prompt correction

A Singular Case of Survival After Acute Methanol Poisoning: Toxicological and Neuroimaging Findings

Am J Forensic Med Pathol, 2014

Acute methanol poisoning is a relatively uncommon and dangerous form of intoxication. It generally occurs after suicidal or accidental events and can be potentially fatal if not diagnosed and treated promptly. Here reported is the case of a 52-year-old Romanian man who survived acute methanol intoxication. Therefore, it was possible to monitor the clinical evolution, the arterial blood gas assay and toxicological research of methanol in blood and urine, as well as the brain damage by computed tomography and magnetic resonance imaging during a period of 20 days after the intake.

Role of Neuroimaging in Methanol Toxicity - a Case Report

Pakistan Armed Forces Medical Journal, 2019

Methanol is a frequently used organic solvent. However toxic doses of methanol may lead to serious metabolic acidosis and neurologic side effects including subarachnoid hemorrhage and sometimes even death. The case described suffered from such poisoning. Diagnosis was made on MRI brain that demonstrated bilateral putamen necrosis a neuro-radiological hallmark of methanol toxicity.

Imaging Findings in Methanol Intoxication

American Journal of Neuroradiology

We present the CT and MR imaging findings in acute methanol intoxication in a 35-year-old man who was admitted to the emergency department with weakness, blurred vision, mild bilateral areactive mydriasis, and a progressive decrease in the level of consciousness. CT and MR imaging showed bilateral putaminal hemorrhagic necrosis and subcortical white matter lesions with peripheral contrast enhancement. There was only partial improvement in patient's Glasgow Coma Scale score during follow-up.

Intracranial hemorrhage associated with methanol intoxication

The Mount Sinai journal of medicine, New York, 2006

Methanol is a common component of gasoline, antifreeze, washer fluid, perfume, household cleaners and various other industrial products. Acute methanol poisoning produces severe metabolic acidosis, serious neurologic sequelae and rarely imaging findings. In this paper, we describe a 35-year-old man with methanol intoxication who was in a comatose stage. Computed tomography (CT) showed widespread brain edema and hemorrhages localized in the supratentorial region of the temporal lobe, nearly 3 x 1 cm in a crescent shape, in the white matter surrounding the capsula externa and extending to the periventricular white matter and occipital lobes. Temporal lobe hemorrhage in our patient might also have been due to the effect of heparinization during hemodialysis, metabolic and lactic acidosis, or formate.

Case Report: Severe brain hypoxic damages after acute methanol poisoning

2022

Methanol poisoning is a challenging clinical situation with irreversible neurologic complication mainly encountered in developed countries. We report a case of a 50-year-old patient who presented with methanol poisoning, symptomatic of respiratory and neurologic failure. In this context, cerebral magnetic resonance imaging concluded entangled injury mechanisms leading to neurologic failure.

Methanol intoxication with cerebral hemorrhage

Neurosciences, 2016

M ethanol is a highly toxic alcohol with a smell and taste similar to ethanol. Small amount around 50-100 ml causes permanent blindness and severe neurological dysfunction leads to death. 1 More than half of methanol related morbidity and mortality is classified as accidental and therefore preventable. In addition, it can be suicidal by ingestion of a variety of commercial paint thinners, gasoline antifreeze , windshield products, organic solvents, shellac varnish, washer fluid, photocopying fluids, perfumes, and in some eau de cologne. Occasionally, it is due to the fraudulent adulteration of wine or other alcoholic beverages. 2 Its ingestion causes high anion gap metabolic acidosis from the production of formic and lactic acids and central nervous system disturbances ranging from inebriation and drowsiness to obtundation, seizure and coma. Selective toxicity of the optic nerve and basal ganglia are well-known features. Bilateral putaminal necrosis is often recognized radiologically in severe methanol toxicity and usually death occurs within 3 days. 2 Here, we report a patient presented with severe high anion gap metabolic acidosis due to methanol intoxication who developed intracerebral bleed during treatment. A 47-year-old man was brought to our hospital by ambulance presented with body pain, nausea, vomiting, and blurring of vision one day ago and sudden loss of vision upon arrival to emergency department. Briefly after admission, became unresponsive, Glasgow Coma Scale 4 with dilated non reactive pupils. His blood pressure was 110/60 mm Hg, heart rate was 95/min, respiratory rate was 32/min (Kussmul's-Kien breathing), and temperature was 36C. An examination of the chest, heart, and abdomen was unremarkable. He was intubated in emergency department and diagnostic work-up started. Chest x-ray was normal, computed tomography of brain showed only atrophic brain changes otherwise normal, (Figure 1), but the Blood Gases showed severe high anion gap metabolic acidosis with the following laboratory results PH 6.78 normal range=7.

Methanol induced intracranial hemorrhage: A rare case report

Bangladesh Journal of Medicine

Intracranial hemorrhage is a rare but fatal complication in methanol poisoning. We report a case of large bilateral basal ganglia hematoma in a 29-years old man with methanol poisoning. He drank alcohol, and was admitted to a tertiary level hospital 6 hours post-ingestion for depressed mental status, lower blood pressure, and high anion gap metabolic acidosis. After fourteen days of methanol exposure, he suddenly developed left sided weakness with one episode of seizure attack. MRI of brain was carried out and showed large intracerebral bleed basal ganglia, specially putaminal and brain edema with midline shift. The uncommon presentation of methanol poisoning is highlighted in this case report. Bangladesh J Medicine 2022; 33: 300-303