Abstract
Objective: Ingested methanol (a toxic alcohol) undergoes enzymatic oxidation to toxic formic acid, resulting in acidosis and formaldehyde which resulted in neurotoxicity specifically optic neuritis and blindness and death in severe poisoning. According to Iranian law, selling, buying and consumption of alcoholic beverages is a punishable crime and people who wish to drink alcohol use industrial or homemade ethanol. Due to depressant effects of methanol on the central nervous system, the objective of this study was to assess the pathologic findings on brain CT scan in methanol poisoned patients beside of their clinical information. Material and method: This prospective study was from Jan 2013 to May 2013. All 20 methanol poisoned patients examined and questionnaires were filled by physician. Brain CT scans without contrast medium were obtained. Results: All of cases were male; their mean age was 33.1 ± 9.2 years. The mortality rate was 15%. Hemodialysis was performed in 85% cases. Mean primary Methanol Level was 22.4 ± 10.5 mg/dL and after hemodialysis was 7.3 ± 6.1. Totally serum methanol levels pre and post hemodialysis were 22.4 and 7.3, respectively. Brain death was recorded in 2 patients. The most common findings at admission were loss of consciousness (n=11) and blurred vision (n=9). The early pathologic brain CT findings were bilateral hypo density lesion in putamen, low attenuation in sub cortical, white matter bilateral hemorrhagic necrosis in putamen and bilateral hypo density in globuspallidus, respectively. Conclusion: In conclusion, it seems CT finding are important as Methanol concentration before any other Para clinic findings and even clinical manifestations.
Highlights
Methanol as a toxic alcohol exists in many solvents, antifreeze solutions, glass cleaner, and paint remover
The early pathologic brain CT findings were bilateral hypo density lesion in putamen, low attenuation in sub cortical, white matter bilateral hemorrhagic necrosis in putamen and bilateral hypo density in globuspallidus, respectively. In conclusion, it seems CT finding are important as Methanol concentration before any other Para clinic findings and even clinical manifestations
Treatment is based on antidote administration such as fomepizole or ethanol. These are for antagonizing methanol oxidation and folic acid to facilitate the catabolism of formic acid, correction of acidosis and dialysis for methanol elimination [1]
Summary
Methanol as a toxic alcohol exists in many solvents, antifreeze solutions, glass cleaner, and paint remover. Treatment is based on antidote administration such as fomepizole or ethanol These are for antagonizing methanol oxidation and folic acid to facilitate the catabolism of formic acid, correction of acidosis and dialysis for methanol elimination [1]. People who wish to drink alcohol use industrial or homemade ethanol that sometimes are a mixture consisting of methanol and ethanol [2]. Both fear of punishment and delayed onset of symptomatic poisoning cause late presentation and are associated with a high mortality rate. This occurs even though patient confidentiality is maintained. The objective of this study was to assess the pathologic findings onbrain CT scan in methanol poisoned patients beside of their clinical information
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