BACKGROUND Acute methanol poisoning(AMP)is a systemic disease that mainly affects the central nervous system and is characterized by ocular damage and metabolic acidosis.If appropriate treatments are inadequate or del...BACKGROUND Acute methanol poisoning(AMP)is a systemic disease that mainly affects the central nervous system and is characterized by ocular damage and metabolic acidosis.If appropriate treatments are inadequate or delayed,the mortality can exceed 40%.As the most serious complication,cerebral hemorrhage is rare with reported prevalence of 7%-19%.CASE SUMMARY A 62-year-old man drank liquor mixed with 45%methanol and 35%alcohol.His vision blurred 10 h later and he fell into coma in another 9 h.Serum toxicological tests were performed immediately,and continuous renal replacement therapy(CRRT)was carried out as the lactic acid exceeded 15 mmol/L and blood pH was 6.78.In addition,the toxicological report revealed 1300.5μg/mL of methanol in serum and 1500.2μg/mL in urine.After 59 h of CRRT,the methanol level decreased to 126.0μg/mL in serum and 151.0μg/mL in urine.However,the patient was still unconscious and his pupillary light reflex was slow.Computed tomography showed hemorrhage in the left putamen.After 16 d of life support treatment,putamen hemorrhage developed into diffuse symmetric intracerebral hemorrhage.In the end,his family gave up and the patient was discharged,and died in a local hospital.CONCLUSION Cerebral hemorrhage requires constant vigilance during the full course of treatment for severe cases of AMP.展开更多
文摘BACKGROUND Acute methanol poisoning(AMP)is a systemic disease that mainly affects the central nervous system and is characterized by ocular damage and metabolic acidosis.If appropriate treatments are inadequate or delayed,the mortality can exceed 40%.As the most serious complication,cerebral hemorrhage is rare with reported prevalence of 7%-19%.CASE SUMMARY A 62-year-old man drank liquor mixed with 45%methanol and 35%alcohol.His vision blurred 10 h later and he fell into coma in another 9 h.Serum toxicological tests were performed immediately,and continuous renal replacement therapy(CRRT)was carried out as the lactic acid exceeded 15 mmol/L and blood pH was 6.78.In addition,the toxicological report revealed 1300.5μg/mL of methanol in serum and 1500.2μg/mL in urine.After 59 h of CRRT,the methanol level decreased to 126.0μg/mL in serum and 151.0μg/mL in urine.However,the patient was still unconscious and his pupillary light reflex was slow.Computed tomography showed hemorrhage in the left putamen.After 16 d of life support treatment,putamen hemorrhage developed into diffuse symmetric intracerebral hemorrhage.In the end,his family gave up and the patient was discharged,and died in a local hospital.CONCLUSION Cerebral hemorrhage requires constant vigilance during the full course of treatment for severe cases of AMP.
