Bilateral putaminal hemorrhages: serious complication of methanol intoxication

CONTEXTMethanol intoxication is a life-threatening condition. Hallmark of clinical presentations include severe wide anion gap metabolic acidosis with very high serum osmolar gap and visual complication. CASE REPORTWe report a case of severe methanol intoxication with bilateral putaminal hemorrhage,...

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Bibliographic Details
Published in:North American journal of medical sciences 2013, Vol.5 (10), p.623-624
Main Authors: Permpalung, Nitipong, Cheungpasitporn, Wisit, Chongnarungsin, Daych, Hodgdon, Travis M
Format: Report
Language:English
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Summary:CONTEXTMethanol intoxication is a life-threatening condition. Hallmark of clinical presentations include severe wide anion gap metabolic acidosis with very high serum osmolar gap and visual complication. CASE REPORTWe report a case of severe methanol intoxication with bilateral putaminal hemorrhage, an uncommon serious complication. A 56-year-old man presented with altered mental status. Fundus examination showed optic disc edema. Arterial Blood Gas (ABG) revealed severe anion gap metabolic acidosis with osmolal gap. Head computed tomography (CT) showed hypodense lesions in basal ganglia bilaterally. Hemodialysis and intravenous fomepizole were initiated. Serum methanol level was significantly elevated. Unfortunately, patient was lethargic 2 weeks after discharge. Repeated CT of head demonstrated new putaminal hemorrhages. CONCLUSIONBilateral putaminal hemorrhage is an uncommon but serious complication in methanol intoxication. Clinicians should have high index of suspicion for putaminal hemorrhage when patients with recent methanol intoxication present with altered mental status.
ISSN:2250-1541
DOI:10.4103/1947-2714.120804