Magnetic resonance imaging and computed tomography scan findings in methanol poisoning

Abstract

Sir, I enjoyed reading the article titled “A rare presentation of methanol toxicity” that was published in your journal.[1] The authors mention that brain lesions typically described in methanol poisoning are in the form of hemorrhagic and non-hemorrhagic necrosis of the basal ganglia and sub-cortical white matter and to their knowledge, lesions in the parietal, temporal, or frontal areas of cerebrum and cerebellar hemispheres have rarely been reported in these patients to date. Therefore, after the presentation of the magnetic resonance imaging (MRI) findings in their patient's brain, the authors state that their case is a rare presentation of infarct in bilateral parasagittal, parieto-occipital and cerebellar regions of the brain. It should be noted that a previously published article,[2] however, gave information about 42 patients with acute methanol poisoning. Of them, 28 (66.6%) had a total of 55 pathological findings on their brain computed tomography (CT) scans, 5 (17.9%) and 7 (25%) of which were bilateral parasagittal hypodense white matter lesions in the occipital and frontal lobes, respectively. In addition, other authors had not only previously reported the same lesions as that of the present Gupta's case but also lesions in the frontal and temporal lobes in the brain CT and MRI of the methanol-poisoned patients.[3 4 5 6 7 8 9 10 11 12 13] This shows that the uni- or bilateral parasagittal, parietal, frontal, temporal, occipital, and cerebellar lesions seen on CT scan and MRI of the brain are documented and not rare complications of methanol poisoning although all these lesions may not concomitantly be present in a single case. If the authors had performed a simple search using PubMed, Google Scholar or SCOPUS, they could easily have retrieved the above-mentioned studies. I suggest the authors to perform an accurate search for their review of the literature.