Asia Pacific Journal of Medical Toxicology

Accident, decreased consciousness, and Alcohol use, which is the cause and which is the effect

Articles in Press

Document Type : Case Report

Authors

Negin Zare Mehrjerdi 1
Alireza Ghassemi Toussi 2

1 Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran

2 Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

10.22038/apjmt.2026.96102.1560
Abstract
Background: Altered levels of consciousness in emergency settings, particularly in the presence of a reported history of alcohol consumption, may lead to misdiagnosis and delayed detection of life-threatening intracranial conditions such as cerebral hemorrhage. This case report aims to highlight the diagnostic challenge of intracerebral hemorrhage presenting with features suggestive of alcohol intoxication and to emphasize the importance of avoiding diagnostic anchoring based on companion reported history.
Case Presentation: This case report describes a 38-year-old male who was admitted to the Poisoning Department of Imam Reza Hospital in 2025 with a decreased level of consciousness and suspected alcohol intoxication. Initial clinical assessments and laboratory investigations were performed. Owing to persistent neurological impairment, brain computed tomography was subsequently obtained.
Discussion: Clinical assessment was initially confounded by reported alcohol use; however, neuroimaging confirmed a significant intracerebral hemorrhage. Retrospective evaluation revealed a neglected history of minor trauma, illustrating the critical importance of excluding structural brain injuries in patients with altered consciousness, regardless of reported intoxication.
Conclusion: This case underscores the necessity of prioritizing objective clinical assessment and comprehensive neurological examination over third-party history in patients with altered mental status. Early consideration of structural brain injury and timely neuroimaging are crucial to preventing diagnostic delay and reducing adverse clinical and medicolegal outcomes.

Keywords

Intracerebral hemorrhage
Methanol
Decreased consciousness
Diagnostic
Effect
Subjects
Asia Pacific Journal of Medical Toxicology

Articles in Press, Accepted Manuscript
Available Online from 29 July 2026

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