Necrosis of the putamen can occur as a result of several factors.
Diagnosis can be made by MRI of the brain with bilateral, symmetric hyperintense lesions on T2-weighted images.
The most common cause is methanol poisoning (via the active metabolite formic acid).
Other causes include:
(1) ischemic injury and/or hypoxia
(2) metabolic acidosis
(3) Wilson's disease
(4) mitochrondrial encephalopathy (hereditary spastic dystonia)
(5) bronopol intoxication (also with formation of formic acid)
(6) ethylene glycol intoxication
(7) cyanide
(8) measles or other viral encephalitis
