Presentation
Decreased level of consciousness and blurring of vision.
Patient Data
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Bilateral fairly symmetrical hypodensities and hemorrhagic areas are seen in both putamina in addition to symmetrical bi-frontal lobe subcortical white matter hypodensities. The appearances are in keeping with acute methanol toxicity. Apart from sinusitis, no other gross abnormality seen.
Case Discussion
There was a history of recent oral ingestion of a large amount of methanol.
Methanol is highly toxic causing cell hypoxia/tissue necrosis. Putamen is particularly affected by this process, presumably due to its high metabolic rate but other basal ganglia nuclei, subcortical white matter and cerebellum can also be affected.