Methanol toxicity

Case contributed by Mahmoud Naga Awad Rezk
Diagnosis almost certain

Presentation

Decreased level of consciousness and blurring of vision.

Patient Data

Age: 40 years
Gender: Male
ct

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.

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