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Methanol Intoxication-Associated Brain Hemorrhages: Can Early Detection Be Life-Saving? A Case Report

Patient: Male, 42-year-old Final Diagnosis: Brain hemorrhage Symptoms: Altered mental status Medication:— Clinical Procedure: — Specialty: Forensic Medicine • General and Internal Medicine • Neurology OBJECTIVE: Rare disease BACKGROUND: Methanol can cause many acute complications when ingested, eith...

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Autores principales: Decker, Megan E., Briski, Nicholas D., Salem, Amira, Noor, Emad, Khashan, Abdallah
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9896127/
https://www.ncbi.nlm.nih.gov/pubmed/36710478
http://dx.doi.org/10.12659/AJCR.938749
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author Decker, Megan E.
Briski, Nicholas D.
Salem, Amira
Noor, Emad
Khashan, Abdallah
author_facet Decker, Megan E.
Briski, Nicholas D.
Salem, Amira
Noor, Emad
Khashan, Abdallah
author_sort Decker, Megan E.
collection PubMed
description Patient: Male, 42-year-old Final Diagnosis: Brain hemorrhage Symptoms: Altered mental status Medication:— Clinical Procedure: — Specialty: Forensic Medicine • General and Internal Medicine • Neurology OBJECTIVE: Rare disease BACKGROUND: Methanol can cause many acute complications when ingested, either intentionally or accidentally. One rare complication is cerebral hemorrhage, which can present with focal neurologic deficits, decreased consciousness, and fixed, dilated pupils. With vigilant monitoring of patients in the acute period of toxicity, rapid identification, and initiation of treatment, outcomes can potentially be improved in these patients. CASE REPORT: We present a case of a 42-year-old man who presented after ingestion of windshield wiper fluid. Initial symptoms started with fatigue and altered mental status, but he quickly developed abdominal pain and became obtunded. CT initially showed no acute hemorrhage or other pathology, but on day 2, despite receiving fomepizole, bicarbonate, and dialysis, the patient became hypotensive and showed loss of cranial nerve reflexes, and repeated CT head scans showed acute intracranial hemorrhage with mass effect. CONCLUSIONS: Although the exact mechanism of intracranial hemorrhage and necrosis following methanol intoxication remains uncertain, we know beyond doubt that it can progress rapidly and lead to severe and irreversible complications, so identifying and treating it immediately is essential. In this case, methanol ingestion was known on presentation, antidote and renal replacement therapy were initiated within hours of ingestion, yet our patient still suffered fatal brain hemorrhage. Important warning signs of acute hemorrhage include loss of cranial nerve reflexes and decrease in consciousness, so these findings warrant further evaluation and prompt neuroimaging, especially in high-risk patients like the one in this report.
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spelling pubmed-98961272023-02-07 Methanol Intoxication-Associated Brain Hemorrhages: Can Early Detection Be Life-Saving? A Case Report Decker, Megan E. Briski, Nicholas D. Salem, Amira Noor, Emad Khashan, Abdallah Am J Case Rep Articles Patient: Male, 42-year-old Final Diagnosis: Brain hemorrhage Symptoms: Altered mental status Medication:— Clinical Procedure: — Specialty: Forensic Medicine • General and Internal Medicine • Neurology OBJECTIVE: Rare disease BACKGROUND: Methanol can cause many acute complications when ingested, either intentionally or accidentally. One rare complication is cerebral hemorrhage, which can present with focal neurologic deficits, decreased consciousness, and fixed, dilated pupils. With vigilant monitoring of patients in the acute period of toxicity, rapid identification, and initiation of treatment, outcomes can potentially be improved in these patients. CASE REPORT: We present a case of a 42-year-old man who presented after ingestion of windshield wiper fluid. Initial symptoms started with fatigue and altered mental status, but he quickly developed abdominal pain and became obtunded. CT initially showed no acute hemorrhage or other pathology, but on day 2, despite receiving fomepizole, bicarbonate, and dialysis, the patient became hypotensive and showed loss of cranial nerve reflexes, and repeated CT head scans showed acute intracranial hemorrhage with mass effect. CONCLUSIONS: Although the exact mechanism of intracranial hemorrhage and necrosis following methanol intoxication remains uncertain, we know beyond doubt that it can progress rapidly and lead to severe and irreversible complications, so identifying and treating it immediately is essential. In this case, methanol ingestion was known on presentation, antidote and renal replacement therapy were initiated within hours of ingestion, yet our patient still suffered fatal brain hemorrhage. Important warning signs of acute hemorrhage include loss of cranial nerve reflexes and decrease in consciousness, so these findings warrant further evaluation and prompt neuroimaging, especially in high-risk patients like the one in this report. International Scientific Literature, Inc. 2023-01-30 /pmc/articles/PMC9896127/ /pubmed/36710478 http://dx.doi.org/10.12659/AJCR.938749 Text en © Am J Case Rep, 2023 https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) )
spellingShingle Articles
Decker, Megan E.
Briski, Nicholas D.
Salem, Amira
Noor, Emad
Khashan, Abdallah
Methanol Intoxication-Associated Brain Hemorrhages: Can Early Detection Be Life-Saving? A Case Report
title Methanol Intoxication-Associated Brain Hemorrhages: Can Early Detection Be Life-Saving? A Case Report
title_full Methanol Intoxication-Associated Brain Hemorrhages: Can Early Detection Be Life-Saving? A Case Report
title_fullStr Methanol Intoxication-Associated Brain Hemorrhages: Can Early Detection Be Life-Saving? A Case Report
title_full_unstemmed Methanol Intoxication-Associated Brain Hemorrhages: Can Early Detection Be Life-Saving? A Case Report
title_short Methanol Intoxication-Associated Brain Hemorrhages: Can Early Detection Be Life-Saving? A Case Report
title_sort methanol intoxication-associated brain hemorrhages: can early detection be life-saving? a case report
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9896127/
https://www.ncbi.nlm.nih.gov/pubmed/36710478
http://dx.doi.org/10.12659/AJCR.938749
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