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Non-aneurysmal and non-traumatic subarachnoid hemorrhage after attempted suicide by incomplete hanging

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ABSTRACT

Hanging is a common method of suicide that is being reported more frequently in many countries. Several complications including injuries to the cervical spine, neck vessels, and brain can occur after attempted suicide by hanging. There are only a few reports of brain computed tomography and magnetic resonance imaging of hanging victims. The most common abnormality was diffuse cerebral edema. A subarachnoid hemorrhage is an atypical complication by suicidal hanging. We report a case of a female patient who presented to an emergency department with altered mental status after attempting suicide by incomplete hanging. The patient was diagnosed with a non-aneurysmal and non-traumatic subarachnoid hemorrhage. This case shows that spontaneous subarachnoid hemorrhage can develop due to a sudden elevation of intracranial pressure, as occurs with hanging.

No MeSH data available.


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(A) A brain computed tomography scan of a patient demonstrating acute subarachnoid hemorrhage in quadrigeminal plate cistern. (B) A cerebral computed tomography angiography scan of a patient demonstrating no vascular abnormality such as cerebral aneurysm or arteriovenous malformation.
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f1-ceem-15-115: (A) A brain computed tomography scan of a patient demonstrating acute subarachnoid hemorrhage in quadrigeminal plate cistern. (B) A cerebral computed tomography angiography scan of a patient demonstrating no vascular abnormality such as cerebral aneurysm or arteriovenous malformation.

Mentions: Brain CT was performed and showed a SAH in the quadrigeminal plate cistern of the brain (Fig. 1A). The cervical spine CT showed no abnormalities. On day 2, the patient became alert and was extubated. A neurologic examination was performed to evaluate mental status and to identify any motor weaknesses, sensory disturbances, or other neurologic abnormalities. The patient was alert, and no other abnormalities were observed upon neurological examination. On day 4, we performed another brain CT. The SAH did not change in comparison with the previous CT, and there was no evidence of hypoxic brain injury. On day 5, we performed a brain angiography CT and transfemoral cerebral angiography to identify any abnormal vascular features, such as a cerebral aneurysm or arteriovenous malformation. No vascular abnormalities were found (Fig. 1B). The patient was treated conservatively for 6 days and then discharged.


Non-aneurysmal and non-traumatic subarachnoid hemorrhage after attempted suicide by incomplete hanging
(A) A brain computed tomography scan of a patient demonstrating acute subarachnoid hemorrhage in quadrigeminal plate cistern. (B) A cerebral computed tomography angiography scan of a patient demonstrating no vascular abnormality such as cerebral aneurysm or arteriovenous malformation.
© Copyright Policy
Related In: Results  -  Collection

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Show All Figures
getmorefigures.php?uid=PMC5385506&req=5

f1-ceem-15-115: (A) A brain computed tomography scan of a patient demonstrating acute subarachnoid hemorrhage in quadrigeminal plate cistern. (B) A cerebral computed tomography angiography scan of a patient demonstrating no vascular abnormality such as cerebral aneurysm or arteriovenous malformation.
Mentions: Brain CT was performed and showed a SAH in the quadrigeminal plate cistern of the brain (Fig. 1A). The cervical spine CT showed no abnormalities. On day 2, the patient became alert and was extubated. A neurologic examination was performed to evaluate mental status and to identify any motor weaknesses, sensory disturbances, or other neurologic abnormalities. The patient was alert, and no other abnormalities were observed upon neurological examination. On day 4, we performed another brain CT. The SAH did not change in comparison with the previous CT, and there was no evidence of hypoxic brain injury. On day 5, we performed a brain angiography CT and transfemoral cerebral angiography to identify any abnormal vascular features, such as a cerebral aneurysm or arteriovenous malformation. No vascular abnormalities were found (Fig. 1B). The patient was treated conservatively for 6 days and then discharged.

View Article: PubMed Central - PubMed

ABSTRACT

Hanging is a common method of suicide that is being reported more frequently in many countries. Several complications including injuries to the cervical spine, neck vessels, and brain can occur after attempted suicide by hanging. There are only a few reports of brain computed tomography and magnetic resonance imaging of hanging victims. The most common abnormality was diffuse cerebral edema. A subarachnoid hemorrhage is an atypical complication by suicidal hanging. We report a case of a female patient who presented to an emergency department with altered mental status after attempting suicide by incomplete hanging. The patient was diagnosed with a non-aneurysmal and non-traumatic subarachnoid hemorrhage. This case shows that spontaneous subarachnoid hemorrhage can develop due to a sudden elevation of intracranial pressure, as occurs with hanging.

No MeSH data available.


Related in: MedlinePlus