Citation

Zakharov S, Kotikova K, Vaneckova M, Seidl Z, Nurieva O, Navratil T, Cagáňová B, Pelclova D. Basic Clin. Pharmacol. Toxicol. 2016; 119(2): 228-238.

Affiliation

Charles University in Prague and General University Hospital, First Faculty of Medicine, Department of Occupational Medicine, Toxicological Information Center, Prague, Czech Republic.

Copyright

(Copyright © 2016, Nordic Pharmacological Society, Publisher John Wiley and Sons)

DOI

10.1111/bcpt.12559

PMID

26806851

Abstract

The purpose was to study the prevalence and predisposing factors of brain lesions in survivors of acute methanol poisoning. Clinical data on 106 patients with methanol poisoning were collected during the Czech mass poisoning outbreak. Of 83 survivors, in 46 (55%) patients follow-up examinations including magnetic resonance imaging of brain (MR) were performed 3-8 and 24-28 months after discharge from the hospital. Of 46 patients with a median age of 49 (interquartile range, IQR 35-57) years, 24 (52%) patients had a total of 40 abnormal brain findings with haemorrhagic lesions detected in 15 (33%) and non-haemorrhagic lesions found in 9 (19%) patients. The patients with haemorrhagic brain lesions were more acidemic (lower arterial blood pH, higher base deficit) and had higher glycaemia and lactacidaemia on admission than those without haemorrhages (all p<0.05). 13/32 (41%) of patients with systemic anticoagulation and 2/14 (14%) of patients without it had haemorrhagic lesions (p=0.080). Bleeding complications during the treatment occurred in 4/15 (27%) patients, and 5/15 (33%) patients had conditions predisposing to haemorrhage in the group with haemorrhagic lesions. In 3 cases with a series of CT/MR performed during hospitalization, the necrotic lesions in the brain remained non-haemorrhagic during hospitalization and haemorrhagic lesions were detected on the follow-up MR examinations only. No association between brain haemorrhages and systemic anticoagulation during dialysis was found: brain haemorrhages might occur in severely poisoned patients treated without systemic anticoagulation, whereas treatment with high doses of heparin might not lead to brain haemorrhages. This article is protected by copyright. All rights reserved.

Language: en