Bilateral putaminal necrosis in a comatose patient with metabolic acidosis

We present a case of acute-onset coma in a young woman, associated with metabolic acidosis, respiratory distress, and hypotension. Magnetic resonance imaging of the brain done on day 2 of admission showed features of bilateral putaminal necrosis. History of methanol ingestion, though not forthcoming...

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Bibliographic Details
Published inIndian journal of critical care medicine Vol. 20; no. 12; pp. 745 - 748
Main Authors Kumar, Sudhir, Reddy, Chenna, Prabhakar, Subhashini
Format Journal Article
LanguageEnglish
Published India Wolters Kluwer India Pvt. Ltd 01.12.2016
Medknow Publications and Media Pvt. Ltd
Jaypee Brothers Medical Publishers Ltd
Medknow Publications & Media Pvt Ltd
Subjects
Acidosis
Care and treatment
Case Report
Coma
Development and progression
Health aspects
Necrosis
India
Coma
metabolic acidosis
methanol toxicity
putaminal necrosis
high anion gap
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Summary:We present a case of acute-onset coma in a young woman, associated with metabolic acidosis, respiratory distress, and hypotension. Magnetic resonance imaging of the brain done on day 2 of admission showed features of bilateral putaminal necrosis. History of methanol ingestion, though not forthcoming at admission, was confirmed later after the patient regained consciousness. A final diagnosis of methyl alcohol toxicity resulting in severe metabolic acidosis, coma, and bilateral blindness was made. This case is reported to emphasize the point that the finding of bilateral putaminal necrosis in a patient with coma and metabolic acidosis is virtually diagnostic of methyl alcohol toxicity even in the absence of any positive history.
ISSN:0972-5229
1998-359X
DOI:10.4103/0972-5229.195720