Journal of Medical and Surgical Intensive Care Medicine 2019 , Vol 10, Issue 2
Cranial Computed Tomography Findings in Methanol Intoxication: Two Case Reports
Tuğçe MENGİ 1 ,Ural Can EKMEKÇİ 2 ,Bilgin CÖMERT 3 ,Ali Necati GÖKMEN 2
1Dokuz Eylül Üniversitesi Tıp Fakültesi, Nöroloji Anabilim Dalı, İzmir, Türkiye
2Dokuz Eylül Üniversitesi Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, İzmir, Türkiye
3Dokuz Eylül Üniversitesi Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, İzmir, Türkiye
DOI : 10.33381/dcbybd.2019.2121 Computed tomography (CT) may show toxic effects of methanol on central nervous system in acute methanol intoxication, which may be helpful in diagnosing and predicting prognosis. In this article we discussed two cases of acute methanol intoxication with neuroimaging findings.

Case 1: A 67-year-old male patient presented with loss of vision. There was a history of chronic alcoholism and alcohol consumption approximately 12 hours ago. Glasgow Coma Score (GCS) was 14. Cranial CT revealed hypodensities in putamen bilaterally. Control cranial CT of the patient with neurological progression showed diffuse hypodense areas in bilateral cerebral subcortical white matter. The time between first CT and control CT was 4 days. Modified Rankin Score was 5 while being discharged from intensive care unit.

Case 2: A 65-year-old male patient presented with unconsciousness. There was a history of chronic alcoholism and alcohol consumption approximately 16 hours ago. His GCS was 7. Cranial CT revealed the hypodensities in bilateral frontal lobe subcortical white matter. In the control cranial CT of the patient experiencing status epilepticus, diffuse hypodens areas were detected in bilateral putamen and bilateral cerebral subcortical white matter. The time between first CT and control CT was 1 day. The patient with neurological progression in the follow-up was diagnosed to have brain death.

In acute methanol intoxication, it is important to predict in which patients the outcome will be worse. The time of onset of neuroimaging findings, the anatomic localization of the lesions and the progression of the lesions in the control imaging may be useful in predicting the prognosis. Keywords : Methanol, Computed tomography, Putamen, Intensive care