Case courtesy of Dr Vimala
63yr male underlying hypertension. Current issue: resolved severe met acidosis secondaery to ? traditional meds, TRO methanol poisoning. Unequal pupils. TRO ICB.
Presence of hypodensities involving both lentiform nuclei (more pronouced at the putaminal regions) as well as corpus callosum.
There are also subcortical white matter hypodensities at both frontal and occipital lobes.
No intracranial bleed.
No midline shift.
Ventricles and CSF spaces are prominent.
Basal cisterns are preserved.
Brainstem and cerebellum are normal.
No skull bone abnormality.
Visualised paransal sinuses and both mastoid air cells are normal.
Overall features are concerning for toxic leukoencephalopathy ( causes include: methanol , cyanide , organophosphate neurotoxicity).
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