2019 Volume 39 Issue 3 Pages 380-383
A 61-year-old woman was treated as our emergency room chiefly with a consciousness disorder. It was due to methanol intoxication that passed from 24 hours to 36 hours after the passage of time. The estimated methanol blood concentration was 331.5 mg / dL. Considering the fact that metabolism from methanol to formic acid has already progressed since it had already metabolic acidosis with pH 6.713, intermittent blood purification was attempted to remove blood methanol and formic acid. After completion of hemodialysis, the pH was improved up to 7.623, but pupil dilatation occurred after 2 hours, and brain edema with remarkable psuedoSAH was found when head CT was reexamined. Compared with past cases that followed the same course, it was found that the elapsed time was long, and cases with high methanol concentration at the time of visit appeared to tend to cause cerebral edema after hemodialysis. Causes of cerebral edema may be due to re-expansion of nerve cells due to the accumulation of methanol or its metabolite in nerve cells.
