Karayel Ferah, Turan Arzu A, Sav Aydin, Pakis Isil, Akyildiz Elif U, Ersoy Gokhan
Council of Forensic Medicine, Istanbul, Turkey.
Am J Forensic Med Pathol. 2010 Mar;31(1):34-6. doi: 10.1097/PAF.0b013e3181c160d9.
The nervous system has increased susceptibility for methanol intoxication. The aim of this study is to investigate various central nervous system lesions of methanol intoxication in 17 cases autopsied in the mortuary department of the Council of Forensic Medicine in Istanbul, Turkey. The reasons of methanol intoxication in the cases was likely the unwitting ingestion of methanol while drinking illegal alcohol. Survival times ranged from several hours to days. In 8 cases (47%), cerebral edema and in 9 cases (53%) at occipital, temporal and parietal cortex, basal ganglia and pons, petechial bleeding was observed. In addition to these findings, hemorrhagic necrosis were observed in thalamus, putamen, and globus pallidus in 5 cases (29.4%) and, in cerebral cortex in another 3 cases (17.6%). In 3 of the cases (17.6%) in which cerebral edema was found, herniation findings accompanied to the situation and in 2 cases (11.7%), pons bleeding was observed. Around the basal ganglia, in 2 of the cases with hemorrhagic necrosis, the situation ended with a ventricular compression. In 7 cases (41%), the associated findings of chronic ischemic changes in cortical neurons, lacunae formation, degeneration of granular cell layer of the cerebellum, and reactive gliosis were considered as the results of chronic alcoholism.
神经系统对甲醇中毒的易感性增加。本研究旨在调查在土耳其伊斯坦布尔法医委员会停尸房进行尸检的17例甲醇中毒患者的各种中枢神经系统病变。这些病例中甲醇中毒的原因可能是饮用非法酒精时无意中摄入了甲醇。存活时间从数小时到数天不等。8例(47%)出现脑水肿,9例(53%)在枕叶、颞叶和顶叶皮质、基底神经节和脑桥观察到点状出血。除这些发现外,5例(29.4%)在丘脑、壳核和苍白球观察到出血性坏死,另外3例(17.6%)在大脑皮质观察到出血性坏死。在发现脑水肿的3例(17.6%)病例中,伴有脑疝表现,2例(11.7%)观察到脑桥出血。在基底神经节周围,2例出血性坏死病例的情况以脑室受压告终。7例(41%)中,皮质神经元慢性缺血改变、腔隙形成、小脑颗粒细胞层变性和反应性胶质增生等相关表现被认为是慢性酒精中毒的结果。