Citation

Kaimori R, Nishida H, Murata K, Tamura M, Kuroki K, Daa T, Mori S. J. Neuropathol. Exp. Neurol. 2024; ePub(ePub): ePub.

Copyright

(Copyright © 2024, American Association of Neuropathologists, Publisher Lippincott Williams and Wilkins)

DOI

10.1093/jnen/nlae030

PMID

38557743

Abstract

Methanol is a harmful agent. When ingested, it is rapidly absorbed from the gastrointestinal tract and converted into formic acid. Formic acid inhibits cytochrome oxidase in the mitochondrial electron transport chain resulting in severe metabolic acidosis that leads to headache, vomiting, irreversible blindness, and intracranial hemorrhage (1). Methanol is commonly used in industries as a raw material, a solvent, antifreeze, and fuel. It is also found in "moonshine" because it is cheap and accidental ingestions have been reported (2). The use of methanol in suicide and homicide is well-known. In 2020, a false rumor spread in Iran that methanol had an antiviral or a preventable effect on severe acute respiratory syndrome-associated coronavirus 2 infection; this resulted in over 5000 people being hospitalized and approximately 500 deaths (3). Although methanol is widely known to be clinically toxic, the detailed mechanisms underlying the optic nerve damage and bilateral cerebral hemorrhages that result from its ingestion remain unclear. In this report, we present a fatal case in which chronological head imaging was performed following a suicide attempt due to methanol ingestion, with subsequent ultrastructural analysis of postmortem brain tissue.

A 58-year-old man with depression had suicidal thoughts and was taking etizolam. On day 0, he was found unconscious in the restroom of his house after drinking some alcohol and was transferred to the emergency room. Computed tomography (CT) and magnetic resonance imaging (MRI) detected no lesions that could disturb consciousness...

Language: en