Hypoxic–ischemic brain injury is common after cardiac arrest. Severe brain damage can be observed after prolonged brain hypoxia following some intoxications, with certain specificities for methanol [1]. Imaging and mainly magnetic resonance imaging (MRI) is done to assess the amount of central nervous system damage, the prognosis as well as the outcome. We present a case of severe putaminal haemorrhagic necrosis and diffuse white matter damage due to both methanol poisoning and severe hypoxia with a poor prognosis.