Teaching NeuroImages: Brain imaging findings in acute methanol toxicity

A 35-year-old man presented to the hospital in status epilepticus. CT of the head revealed bilateral basal ganglia hemorrhage (figure, A). Serum osmolality was elevated at 372 mmol/kg and methanol level was 34 mmol/L. He was admitted to the intensive care unit. MRI of the brain (figure, B–D) demonstrated extensive white matter diffusion restriction and basal ganglia hemorrhage. Care was withdrawn on postadmission day 6, with the patient dying shortly thereafter. Methanol toxicity classically presents with putaminal necrosis, presumed secondary to cellular hypoxia from formate-induced cytochrome oxidase inhibition.1 Rarely, white matter necrosis is evident on MRI.1

Source: Neurology - November 27, 2017 Category: Neurology Authors: Anderson, D., Beecher, G., Emery, D., Khadaroo, R. G. Tags: CT, MRI, All Toxicology, Alcohol, Other toxicology RESIDENT & amp;amp; FELLOW SECTION Source Type: research