Previously healthy young man, presented with acute onset of confusion and headache for last two days after consuming alcohol.
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Bilateral putaminal haemorrhagic necrosis evident by high signal on T1WI, T2WI and FLAIR sequence with drop out signal on T2* GRE and diffusion restriction.
Fraudulent adulteration of wine is the common cause of acute methanol intoxication in developing countries. The Putamina are the most susceptible sites for damage in methanol intoxication, other hallmarks to be aware of are include diffuse hypo-attenuation in cerebral white matter and haemorrhages.