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.

Encefalopatía tóxica por isopropanol: Sobre-exposición accidental a gas propano

“…Se han comunicado casos de intoxicación por la ingesta de isopropanol 11,12 , donde destacan pacientes que llegaron al coma y presentaron compromiso de la vía motora central, expresado en hiperreflexia y signo de Babinski. La RM mostró hipointensidad de la substancia blanca en T1 e hiperintensidad en T2 que en algún caso comprometió corteza cerebelosa, regiones temporo-mesiales, ganglios basales y tronco encefálico 13 . Estos sujetos después de haber superado el estado tóxico recuperaron su capacidad funcional, aunque mantuvieron un déficit cognitivo de expresión frontal y subcortical 14 .…”