Intracerebral hemorrhage in methanol toxicity patients during COVID-19 pandemic: case report and review of literature

Forensic Toxicol. 2024 Jul;42(2):242-247. doi: 10.1007/s11419-023-00680-y. Epub 2024 Feb 9.

Abstract

Purpose: The aim of this study is to examine the clinical and imaging manifestations of methanol toxicity during the COVID-19 pandemic, as well as to review existing studies on this topic. The most common cause of methanol intoxication is methanol-adulterated liquor. The primary metabolite of methanol, formic acid, is responsible for pathological changes. Symptoms typically present within 6-24 h of consumption and can include visual disturbances, acute neurological symptoms, and gastrointestinal issues. During the initial year of the COVID-19 pandemic, methanol poisoning cases increased significantly.

Methods: In this study, We present six different patients with methanol intoxication and their clinical and imaging features.

Results: In the literature review, the most common clinical presentation was loss of consciousness and obtundation and the other was vision loss. CT scan findings showed bilateral putaminal necrosis and hemorrhage in 55% of methanol toxicity patients.

Conclusion: Methanol intoxication, causing bilateral putaminal involvement and a 50% mortality rate in intracerebral hemorrhage patients, warrants urgent toxicological analysis due to potential putaminal hemorrhage.

Keywords: COVID-19 pandemic; Intracerebral hemorrhage; Methanol toxicity; Putaminal hemorrhage.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Aged
  • COVID-19* / complications
  • Cerebral Hemorrhage / chemically induced
  • Cerebral Hemorrhage / diagnostic imaging
  • Female
  • Humans
  • Male
  • Methanol* / poisoning
  • Middle Aged
  • Putaminal Hemorrhage / chemically induced
  • Putaminal Hemorrhage / diagnostic imaging
  • Putaminal Hemorrhage / pathology
  • Tomography, X-Ray Computed*
  • Unconsciousness / chemically induced

Substances

  • Methanol