title: Magnetic resonance imaging features of brain and spinal cord injury in a fatal case of isopropanol intoxication.
abstract: A 60-year-old man presented with headache, dizziness, and disorientation one day after consumption of isopropanol along with ethanol. Computed tomography (CT) of the brain performed immediately was unremarkable. The patient collapsed within the hospital 30 minutes after the CT scan was done, and remained comatose until death, showing no improvement with symptomatic treatment. Magnetic resonance imaging of the brain and spine done 6 days after admission revealed bilaterally symmetrical hyperintensities involving the cerebral and cerebellar cortex and white matter, basal ganglia, thalami, and brainstem on T2-weighted, fluid attenuated inversion recovery and diffusion weighted images; similar hyperintensities were seen involving the swollen and edematous cervical spinal cord and cerebellar tonsillar herniation compressing the proximal cervical cord. Petechial hemorrhages were also noted within the brainstem. These features are compatible with toxic injury to the brain and cervical spinal cord. To our knowledge, the magnetic resonance imaging features of brain and spinal cord injury and cerebellar tonsillar herniation, secondary to isopropanol intoxication have not been reported in the published literature before.
authors.affiliation: Department of Radiology, Al-Khor Hospital, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Parag Suresh
authors.initials: PS
authors.lastname: Mahajan
authors.affiliation: Department of Medicine, Al-Khor Hospital, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Joyal Jacob
authors.initials: JJ
authors.lastname: Mathew
authors.affiliation: Department of Radiology, Al-Khor Hospital, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Abhilash Pulincherry
authors.initials: AP
authors.lastname: Jayaram
authors.affiliation: Department of Radiology, Al-Khor Hospital, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Vidya Chander
authors.initials: VC
authors.lastname: Negi
authors.affiliation: Department of Medicine, Al-Khor Hospital, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Mohamed Milad
authors.initials: MM
authors.lastname: Abu Hmaira
keywords: alcohol intoxication; computed tomography; ethyl alcohol; isopropyl alcohol; toxicity
references.citation: N Engl J Med. 2007 Feb 1;356(5):530-1
references.pmid: 17267921
references.citation: Clin J Am Soc Nephrol. 2008 Jan;3(1):208-25
references.pmid: 18045860
references.citation: J Gen Intern Med. 2012 Jul;27(7):876-7
references.pmid: 22362126
references.citation: Am J Med Sci. 2010 Mar;339(3):276-81
references.pmid: 20090509
references.citation: Case Rep Radiol. 2013;2013:602981
references.pmid: 23762729
references.citation: AJR Am J Roentgenol. 2009 Sep;193(3):879-86
references.pmid: 19696305