1996 Volume 3 Issue 3 Pages 235-239
We report a case of severe methanol intoxication which resulted in brain death. A 42-year-old man with abdominal pain and vomiting was admitted to an emergency hospital. He had severe metabolic acidosis and soon became comatose. He was transferred to our ICU immediately after tracheal intubation. On arrival, he was in deep coma with high plasma osmotic pressure and an increase in the osmolal gap. A brain CT-scan showed bilateral decrease in density in the lenticular nuclei suggesting methanol intoxication. Continuous hemodialysis was begun and the patient's metabolic acidosis and high plasma osmotic pressure improved rapidly. Diabetes insipidus developed 16 hours later and a CT-scan revealed severe brain swelling. Brain death subsequently ensued.
The blood methanol concentration was 173mg·dl-1 seven hours after admission to the ICU. We believe that brain death was due to the direct effect of methanol and its metabolites with subsequent brain edema.
