An Autopsy Case Report of Homicide by Methanol Intoxication With Pinkish Bilateral Putamina
An Autopsy Case Report of Homicide by Methanol Intoxication With Pinkish Bilateral Putamina
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双侧粉红色肉质甲醇中毒杀人尸检报告
DOI：
10.1097/paf.0000000000000790
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Ueno Yasuhiro
中科院分区：
文献类型：
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作者：
Takahashi Motonori;Kondo Takeshi;Yamasaki Gentaro;Sugimoto Marie;Yoshida Haruhi;Harada Kazuo;Matsumoto Hiroshi;Asano Migiwa;Ueno Yasuhiro
许多由甲醇引起的死亡是由于故意自杀企图或意外摄入造成的，一些研究人员已经量化了血液和器官中的甲醇和甲酸。然而，据我们所知，没有报告描述了大脑中甲醇浓度的区域差异。一名50多岁的男子喝了妻子故意用甲醇污染的酒，经过4天的血液透析等强化治疗后死于多器官衰竭。法医尸检时，脑横截面显示脑干中有分散的点状出血，双侧壳核中有显微出血伴充血，呈粉红色变色。通过顶空气相色谱法测量了尸检样品中甲醇、甲酸和乙醇的浓度，结果显示尽管甲醇已从血液中消除，但脑中（尤其是基底神经节中）残留的甲醇和甲酸浓度相对较高。即使经过4天的治疗，脑组织的尸检毒理学分析表明甲醇摄入。甲酸的蓄积和随之发生的局部代谢性酸中毒可引起脑损伤。
Many deaths caused by methanol occur as a result of intentional suicide attempts or accidental ingestion, and several investigators have quantified methanol and formic acid in blood and organs. However, to the best of our knowledge, no reports have described regional differences in the concentration of methanol in the brain. A man in his 50s drank alcohol that had been deliberately contaminated with methanol by his wife, and he died of multiple-organ failure after 4 days of intensive medical treatment including hemodialysis. On medicolegal autopsy, cross sections of the brain showed scattered petechial hemorrhage in the brain stem and microscopic hemorrhage with congestion in the bilateral putamina, which showed pinkish discoloration. The concentrations of methanol, formic acid, and ethanol in autopsy samples were measured by headspace gas chromatography, revealing relatively high concentrations of residual methanol and formic acid in the brain (especially in the basal ganglia), although methanol had been eliminated from the blood. Even after 4 days of medical treatment, postmortem toxicological analysis of the brain tissue indicated methanol ingestion. The accumulation of formic acid and the consequent local metabolic acidosis may cause brain lesions.