Pseudo-SAH in a patient with methanol poisoning

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.