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Methanol intoxication with putaminal and white matter necrosis: MR and CT findings
D Rubinstein1, E Escott, J P Kelly
1Department of Radiology, University of Colorado Health Sciences, Denver 80262, USA.
Abstract:
We report a case of methanol intoxication in which the initial CT scans appeared normal. MR at 4 days showed the typical putaminal lesions of methanol intoxication and, in addition, peripheral white matter lesions that spared a thin rim of subcortical white matter. A CT scan at 17 days showed the putaminal and white matter lesions. The white matter lesions correspond well to lesions previously described in pathologic specimens.
Insights
Methanol intoxication can cause brain damage, initially missed by CT scans. MRI revealed characteristic putaminal and peripheral white matter lesions, confirmed later by CT.
Area of Science:
- Neurology
- Radiology
- Toxicology
Background:
- Methanol intoxication is a serious condition that can lead to severe neurological deficits.
- Early diagnosis is crucial for effective management and improved patient outcomes.
Observation:
- A case of methanol intoxication presented with initially normal computed tomography (CT) scans.
- Magnetic resonance (MR) imaging performed 4 days post-exposure revealed characteristic putaminal lesions.
- Peripheral white matter lesions, sparing the subcortical rim, were also observed on MR imaging.
Findings:
- Follow-up CT scan at 17 days demonstrated both putaminal and white matter lesions.
- The observed white matter lesions correlated with previously documented pathological findings.
- MR imaging proved more sensitive than initial CT for detecting early neurological damage in methanol intoxication.
Implications:
- This case highlights the potential for delayed radiological findings in methanol intoxication.
- It underscores the utility of MR imaging in diagnosing methanol-induced brain injury when CT is inconclusive.
- Early and accurate neuroimaging is vital for guiding treatment and predicting prognosis in toxic encephalopathies.