Question 2380
{"accessible":true,"alternatives":[{"id":11732,"text":"Marchiafava-Bignami disease"},{"id":11734,"text":"methanol poisoning"},{"id":11733,"text":"osmotic demyelination syndrome"},{"id":11735,"text":"uremic encephalopathy"},{"id":11731,"text":"Wernicke encephalopathy"}],"archived":false,"correctAlternativeId":11734,"explanation":"\u003cp\u003e\u003ca title=\"Methanol poisoning\" class=\"internal\" href=\"/articles/methanol-poisoning\"\u003eMethanol poisoning\u003c/a\u003e is the most likely diagnosis given the pattern of bilateral putaminal hemorrhagic necrosis indicated\u0026nbsp;by the T2 hyperintensities of the putamina and adjacent white matter as well as foci of T2 hypointensity within the putamina. Methanol can contaminate homemade ethanol spirits\u0026nbsp;(moonshine).\u003c/p\u003e\u003cp\u003e\u003ca title=\"Wernicke encephalopathy\" class=\"internal\" href=\"/articles/wernicke-encephalopathy\"\u003eWernicke encephalopathy\u003c/a\u003e is incorrect as it would involve structures around the third and fourth ventricles such as the thalami, midbrain tectum, and mammillary bodies.\u003c/p\u003e\u003cp\u003e\u003ca title=\"Marchiafava-Bignami disease\" class=\"internal\" href=\"/articles/marchiafava-bignami-disease-1\"\u003eMarchiafava-Bignami disease\u003c/a\u003e is incorrect as it would involve the corpus callosum.\u003c/p\u003e\u003cp\u003e\u003ca title=\"Osmotic demyelination syndrome\" class=\"internal\" href=\"/articles/osmotic-demyelination-syndrome\"\u003eOsmotic demyelination syndrome\u003c/a\u003e could involve the putamina (extrapontine myelinolysis), but the clinical context and presence of hemorrhage are not consistent with this diagnosis.\u003c/p\u003e\u003cp\u003e\u003ca title=\"Uremic encephalopathy\" class=\"internal\" href=\"/articles/uraemic-encephalopathy\"\u003eUremic encephalopathy\u003c/a\u003e could involve bilateral putamina and adjacent white matter, but the clinical context and presence of hemorrhage are not consistent with this diagnosis.\u003c/p\u003e","id":2380,"imageUrl":"https://prod-images-static.radiopaedia.org/images/29479899/40e9debd8550e0b5c8aedafec5ca52_big_gallery.jpeg","imageAttribution":{"kind":"case","rID":52299},"imageAttributionCaseInfo":{"title":"Methanol poisoning","contributor_name":"Hidayatullah Hamidi","contributor_param":"hidayatullah","case_rid":52299,"case_param":"methanol-poisoning"},"firstQuestionPath":"/questions/2380","nextQuestionPath":null,"relatedArticles":[{"id":5627,"title":"Wernicke encephalopathy","link":"/articles/wernicke-encephalopathy?lang=us"},{"id":7232,"title":"Marchiafava-Bignami disease","link":"/articles/marchiafava-bignami-disease-1?lang=us"},{"id":1077,"title":"Osmotic demyelination syndrome","link":"/articles/osmotic-demyelination-syndrome?lang=us"},{"id":37902,"title":"Uremic encephalopathy","link":"/articles/uraemic-encephalopathy?lang=us"}],"alsoUsedIn":[{"id":1345,"kind":"Course","title":"2022 Virtual Conference Private Use - page 1345","link":"https://radiopaedia.org/courses/2022-virtual-conference-private-use/pages/1345"},{"id":1200,"kind":"Course","title":"2022 Virtual Conference Private Use - page 1200","link":"https://radiopaedia.org/courses/2022-virtual-conference-private-use/pages/1200"},{"id":248,"kind":"LiveSchedule","title":"248","link":"https://radiopaedia.org/admin/live_schedules/248"},{"id":156,"kind":"LiveSchedule","title":"156","link":"https://radiopaedia.org/admin/live_schedules/156"},{"id":1262,"kind":"Course","title":"2022 Virtual Conference Private Use - page 1262","link":"https://radiopaedia.org/courses/2022-virtual-conference-private-use/pages/1262"},{"id":1397,"kind":"RestrictedPage","title":"Page 1397 (in no courses)","link":"https://radiopaedia.org/admin/restricted_pages/1397"},{"id":2238,"kind":"Course","title":"Toxic \u0026 Metabolic Brain Disorders in Adults - page 2238","link":"https://radiopaedia.org/courses/toxic-and-metabolic-brain-disorders/pages/2238"},{"id":2238,"kind":"Course","title":"Toxic \u0026 Metabolic Brain Disorders in Adults Peer Review - page 2238","link":"https://radiopaedia.org/courses/toxic-and-metabolic-brain-disorders-peer-review/pages/2238"}],"stem":"\u003cp\u003eA 20-year-old man with a history of alcohol use presents with confusion and headache and is assessed with the MRI shown. What is the most likely diagnosis?\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/2380"}],"attemptsPercentages":[{"alternativeId":"11735","percentage":8},{"alternativeId":"11734","percentage":75},{"alternativeId":"11731","percentage":10},{"alternativeId":"11732","percentage":4},{"alternativeId":"11733","percentage":3}],"promptToLogin":false,"questionManager":false,"articleId":"methanol-poisoning"}