Importance of Susceptibility-weighted-imaging in Methanol Toxicity

Methanol poisoning is a rare but potentially lethal condition. Haemorrhagic necrosis of bilateral basal ganglia, particularly of the putamen, is one of the distinctive features of this entity. One of the proposed responsible mechanisms for putaminal haemorrhagic necrosis due to methanol toxicity is inadequate venous drainage of this region. Advanced imaging modalities are used to guide diagnosis and patient management. Here, we report a 61-year man who had a fulminant acute methanol toxicity due to accidental ingestion. Susceptibility-weighted-imaging (SWI) showed marked bilateral basal ganglia and brainstem haemorrhage. Also, congested and dilated venous structures were detected in SWI, which may be an indirect sign of inadequate venous drainage of this region. We intend to present the cerebral SWI features of a patient with fulminant methanol toxicity in order to clarify the underlying physiopathology of the brain damage, which has not yet been presented in the literature to the best of our knowledge. Key Words: Methanol, Toxic encephalopathy, Magnetic resonance imaging, Cerebral haemorrhage.