Acute methanol poisoning with bilateral diffuse cerebral hemorrhage: A case report
Jin Li1, Zhi-Juan Feng1, Lei Liu1
1Department of Critical Care Medicine, Air Force Medical Center, PLA, Beijing 100142, China.
World Journal of Clinical Cases
|August 18, 2022
Summary
Acute methanol poisoning can lead to severe complications like cerebral hemorrhage. Continuous monitoring and vigilance are crucial throughout treatment for patients with severe methanol poisoning.
Area of Science:
- Toxicology
- Neurology
- Critical Care Medicine
Background:
- Acute methanol poisoning (AMP) is a severe systemic disease with high mortality, primarily affecting the central nervous system and causing ocular damage and metabolic acidosis.
- Cerebral hemorrhage is a rare but serious complication of AMP, with reported prevalence ranging from 7% to 19%.
Observation:
- A 62-year-old male presented with blurred vision and coma after ingesting methanol-laced alcohol.
- Despite immediate toxicological tests and continuous renal replacement therapy (CRRT) for severe metabolic acidosis, the patient developed neurological deficits.
- Computed tomography revealed putaminal hemorrhage, which progressed to diffuse intracerebral hemorrhage despite intensive life support.
Findings:
- High serum methanol levels (1300.5 μg/mL) were detected, requiring 59 hours of CRRT for reduction.
- Neurological deterioration persisted, with unresponsiveness and abnormal pupillary reflexes, indicating significant central nervous system damage.
- The case illustrates the development and progression of cerebral hemorrhage as a severe complication of acute methanol poisoning.
Implications:
- Cerebral hemorrhage necessitates constant vigilance in managing severe acute methanol poisoning cases.
- This case highlights the importance of early detection and aggressive management of methanol poisoning, alongside close neurological monitoring.
- Delayed or inadequate treatment of AMP can lead to devastating neurological outcomes, including fatal cerebral hemorrhage.
