Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 64 7 2026 07 12 410 421 Leila Etemad Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran. AND Department of Pharmaceutical Control, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran. AmirAli Moodi Ghalibaf Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran. Ali Sadr Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Masoud Pezeshki Rad Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Majid Khadem-Rezaiyan Department of Community Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Amir Behforouz Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. AND Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Setareh Azarkar Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran. Asieh Karimani Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran Hossein Ghaffari Organ Transplant Superspecialty Montaserieh Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Mohammad Moshiri Medical Toxicology Research Center, Basic Sciences Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran 2024 07 08 2025 04 02 Methanol poisoning is a severe intoxication that can be fatal. This study aimed to determine the association between clinical and paraclinical findings, particularly brain radiological findings, and the risk of mortality in methanol-poisoned patients. This retrospective cross-sectional study was conducted at the CTD-IRH-MUMS, Mashhad, Iran, from March 2019 to March 2021. Medical and demographic data of adult patients with a confirmed diagnosis of methanol poisoning who had undergone a brain computed tomography (CT) scan were included. A total of 45 methanol-poisoned patients were enrolled in the study, including 36 men (80%) with a mean age of 34.32±13.20 years. Among them, 15 patients (33.3%) had at least one abnormal finding on their brain CT scans. The most frequent finding was diffuse cerebral hemorrhage (n=12, 26.7%), followed by subcortical white matter changes (n=9, 20%), and putaminal hypodensities (n=7, 15.6%). Although abnormal brain CT findings were associated with a higher risk of mortality (OR=4.929, P=0.019), they were not related to any specific type of CT findings. A Glasgow Coma Scale (GCS) score<9 (OR=0.445, P=0.003), respiratory rate>19 breaths/min (OR=2.675, P=0.006), serum creatinine level>1.8 mg/dL (OR=6.258, P=0.009), potassium level>4.3 mEq/L (OR=3.672, P=0.006), glucose level (OR=1.011, P=0.019), bicarbonate level<11.4 mEq/L (OR=0.872, P=0.003), and pH<7.11 (OR=0.001, P=0.003) were predictors of mortality with acceptable sensitivity and specificity. Lower GCS, PCO2, and HCO3 levels, along with higher blood pressure, were associated with a higher incidence of pathological brain CT findings. Physicians should consider acidosis, tachypnea, decreased consciousness, and elevated blood glucose and creatinine levels as predictors of mortality or pathological brain CT findings. https://acta.tums.ac.ir/index.php/acta/article/view/11151 https://acta.tums.ac.ir/index.php/acta/article/download/11151/6071