title: Acute Methanol Poisoning: Prevalence and Predisposing Factors of Haemorrhagic and Non-Haemorrhagic Brain Lesions.
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, 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). Thirteen of 32 (41%) of patients with systemic anticoagulation and 2 of 14 (14%) of patients without it had haemorrhagic lesions (p = 0.080). Bleeding complications during the treatment occurred in 4 of 15 (27%) patients, and 5 of 15 (33%) patients had conditions predisposing to haemorrhage in the group with haemorrhagic lesions. In three cases with a series of computer tomography (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.
authors.affiliation: First Faculty of Medicine, Department of Occupational Medicine, Toxicological Information Center, Charles University in Prague and General University Hospital, Prague, Czech Republic.
authors.forename: Sergey
authors.initials: S
authors.lastname: Zakharov
authors.affiliation: First Faculty of Medicine, Department of Occupational Medicine, Toxicological Information Center, Charles University in Prague and General University Hospital, Prague, Czech Republic.
authors.forename: Katerina
authors.initials: K
authors.lastname: Kotikova
authors.affiliation: First Faculty of Medicine, Department of Radiology, Charles University in Prague and General University Hospital, Prague, Czech Republic.
authors.forename: Manuela
authors.initials: M
authors.lastname: Vaneckova
authors.affiliation: First Faculty of Medicine, Department of Radiology, Charles University in Prague and General University Hospital, Prague, Czech Republic.
authors.forename: Zdenek
authors.initials: Z
authors.lastname: Seidl
authors.affiliation: First Faculty of Medicine, Department of Occupational Medicine, Toxicological Information Center, Charles University in Prague and General University Hospital, Prague, Czech Republic.
authors.forename: Olga
authors.initials: O
authors.lastname: Nurieva
authors.affiliation: First Faculty of Medicine, Department of Occupational Medicine, Toxicological Information Center, Charles University in Prague and General University Hospital, Prague, Czech Republic.|Department of Biomimetic Electrochemistry, J. Heyrovsky Institute of Physical Chemistry of AS CR, Prague, Czech Republic.
authors.forename: Tomas
authors.initials: T
authors.lastname: Navratil
authors.affiliation: National Toxicological Information Center, University Hospital Bratislava, Bratislava, Slovakia.
authors.forename: Blazena
authors.initials: B
authors.lastname: Caganova
authors.affiliation: First Faculty of Medicine, Department of Occupational Medicine, Toxicological Information Center, Charles University in Prague and General University Hospital, Prague, Czech Republic.
authors.forename: Daniela
authors.initials: D
authors.lastname: Pelclova
mesh_terms: D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D001921:Brain / Q000187:drug effects* / Q000473:pathology; D001927:Brain Diseases / Q000139:chemically induced / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D005561:Formates / Q000097:blood; D006470:Hemorrhage / Q000139:chemically induced / Q000188:drug therapy / Q000453:epidemiology*; D006493:Heparin / Q000627:therapeutic use; D006760:Hospitalization; D006801:Humans; D006863:Hydrogen-Ion Concentration; D016014:Linear Models; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D000432:Methanol / Q000097:blood / Q000506:poisoning*; D008875:Middle Aged; D011041:Poisoning / Q000188:drug therapy / Q000453:epidemiology*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000925:Anticoagulants; D005561:Formates; C030544:formic acid; D006493:Heparin; D000432:Methanol