Presentation
2 days seizure, headache and nausea.
Patient Data
No acute hemorrhage or infarct. No mass, collections or hydrocephalus.
Large old lentiform nucleus infarcts bilaterally, consistent with background of previous methanol poisoning.
Normal ventricles and CSF spaces.
Unremarkable bones, soft tissues and air spaces.
Case Discussion
In this case the information regarding the previous methanol poisoning was not included in the clinical request. Acute methanol poisoning is classically seen as hypo-attenuation bilaterally in the putamen, reflective of putaminal necrosis. Here, the methanol poisoning was in the context of deliberate self harm many years previously, leaving large CSF attenuation regions in the region of the lentiform nuclei. The patient had been blind since the initial poisoning.