Unusual cause of spontaneous unilateral intracerebral hematoma-acute methanol poisoning: case report

Brain hemorrhage is a rare but lethal complication in methanol poisoning. We report a case of massive unilateral intraparenchymatous insular hematoma in a 34-year-old woman with unintentional methanol poisoning. She was admitted to a territorial hospital 72 hours post-ingestion of an unknown dose of methanol for high anion gap metabolic acidosis and confusion. Computed tomographic (CT) scan showed lesions in putamen and cerebral deep white matter. Sixteen days after methanol exposure, she suddenly developed coma, followed by cardiorespiratory arrest. A second CT scan revealed massive unilateral intraparenchymatous insular hematoma which led to death. Emergency physicians should be aware of this unusual complication of a methanol exposure.