The clinical manifestations of methanol poisoning have been the subject of several review articles over the past forty years (2, 11), though de tailed post mortem pathologic studies are relatively few. The earliest autopsy studies on methanol poisoning have emphasized the acute changes secondary to hypoxic or ischemic in jury to the gray matter, cerebral oedema and acute neuronal in jury. Post mortem studies of individuals, who survive intoxication several days or weeks have shown brain in jury characterized by bilateral putamen necrosis, particularly affecting the lateral portions of the nuclei (1, 10). In some of the cases there has also been a dramatic pattern of white matter hemorrhagic necrosis, involving the centrum semiovale, especially affecting subcortical regions /10/. The precise mechanism of methanol toxicity remains a matter of debate /2/. The observed lesions represent direct toxic effects of methanol and its metabolites and injury, secondary to anoxia and acidosis. In jury to the putamen likely represents a selective toxic effect, possibly potentiated by poor venous drain age. The pathogenesis of the white matter hemorrhagic necrosis remains unexplained /6/.
Scripta Scientifica Medica 2008; 40(2): 175-176.