Objective: Methanol poisoning is a dangerous life-threatening event, manifested with
various symptoms, sometimes very rare ones, that all should be addressed to prevent
misdiagnosis of the methanol-poisoned patients.
Case Presentation: A 21-year-old young man was brought to the emergency department
(ED) with a generalized tonic-clonic (GTC) seizure and he was diagnosed with methanol
intoxication. A non-contrast computed tomography (NCCT) of the brain demonstrated
findings similar to subarachnoid hemorrhage (SAH). After the brain CT, he had a Glasgow
Coma Score (GCS) of 3 and all brainstem reflexes were absent. Neurology consultant
agreed with the diagnosis of pseudo-SAH. Brain death was confirmed by a positive apnea
test within 24 hours of presentation.
Conclusion: It is suggested that compression of dural sinuses due to severe brain edema,
reduces the venous drainage and leads to venous engorgement, which appears high
attenuated in the background of low-density edematous brain matter.