ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ HÌNH ẢNH HỌC NÃO TRÊN BỆNH NHÂN NGỘ ĐỘC CẤP METHANOL

Abstract

Objective: Describe the clinical, paraclinical and imaging of brain parenchymal lesions in patients with acute methanol poisoning. Methods: Retrospective description of 86 patients (83 men and 3 women, average age 52.86 ± 11.73 years) diagnosed with acute methanol poisoning and underwent computed tomography (CT) or magnetic resonance imaging (MRI) of the brain at Bach Mai Hospital for clinical, paraclinical and brain imaging characteristics. Results: The results of CT/MRI imaging of the brain showed that 68/86 (79.1%) patients had brain parenchymal lesions. Of which, bilateral symmetrical lesions of the putamen accounted for 37.2%, cerebral hemorrhage (29.1%), diffuse cerebral edema (24.4%), subcortical white matter lesions (24.4%), subarachnoid hemorrhage (3.4%), and cerebellar lesions (8.1%). These findings were associated with blood pH, Glasgow Coma Scale (GCS), alcoholism, positive PXAS, pO2, lactate, hyperosmolarity, increased osmolarity gap, and methanol concentration (p < 0.05). The brain lesions on CT/MRI most predictive of poor prognosis were bilateral symmetrical putamen lesions, intracerebral hemorrhage, diffuse cerebral edema, subcortical white matter lesions. Conclusion: Patients with acute methanol poisoning who have severe acidosis, low GCS, low pH, low oxygen saturation, and high glucose concentration should undergo brain imaging. Brain lesions provide valuable information for the diagnosis and management of patients with acute methanol poisoning.